Endoscope and endoscope system thereof

ABSTRACT

Guide wire fixing means is provided for an insertion portion of an endoscope, and a guide wire is releasably engaged when inserting/removing a therapeutic instrument running on the guide wire with a distal end portion of the guide wire inserted into a therapeutic instrument insertion channel of the endoscope being led out from a distal end opening portion of the channel.

CROSS-REFERENCE TO RELATED APPLICATIONS

This is a Continuation Application of PCT Application No.PCT/JP01/03286, filed Apr. 17, 2001, which was not published under PCTArticle 21(2) in English.

This application is based upon and claims the benefit of priority fromthe prior Japanese Patent Applications No. 2000-115355, filed Apr. 17,2000, No. 2000-128262, filed Apr. 27, 2000, No. 2000-145530, filed May17, 2000; and No. 2001-104390, filed Apr. 3, 2001, the entire contentsof all of which are incorporated herein by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to an endoscope and an endoscope systemwith which can be replaced a therapeutic instrument by using a guidewire in endoscopy or endoscopic surgery of pancreaticobiliary ducts inparticular.

2. Description of the Related Art

In recent years, use of an endoscopic treatment for treatment of adisorder in an alimentary canal system and a pancreaticobiliary ductsystem is increasing. As the current treatment for thepancreaticobiliary duct system using an endoscope, there is a diagnostictreatment for endoscopically imaging a bile duct or a pancreatic duct aswell as therapeutic treatment for collecting a bile stone existing in acholedoch duct by a balloon or a gripping therapeutic instrument.

Further, in the endoscopic treatment for a pancreatic duct, a bile ductor a hepatic duct, an end of an insertion portion of the endoscope isinserted to the vicinity of the duodenal papilla, and a therapeuticinstrument such as a catheter is then selectively inserted into thepancreatic duct or the bile duct with a guide wire as a guide inradioscopy.

Furthermore, when performing endoscopic treatment for a pancreatic duct,a bile duct or a hepatic duct by using the endoscope, the end of theinsertion portion of the endoscope is usually inserted to the vicinityof the duodenal papilla, and a therapeutic instrument such as a catheteris then generally selectively inserted into the pancreatic duct or thebile duct with the guide wire as a guide, in radioscopy.

Specifically, the following operation is carried out. At first, after anend portion 903 of an insertion portion 902 of an endoscope 901 shown inFIGS. 114A and 114B is inserted to the vicinity of duodenal papilla inadvance, a catheter 904 is inserted into a therapeutic instrumentinsertion channel of the endoscope 901, and an end portion 904 a of thecatheter 904 is endoscopically inserted into the pancreatic duct or thebile duct. Then, a guide wire 905 is inserted from a mouth ring 904 b ofthe inserted catheter 904 on the base end side.

Thereafter, in radioscopy, it is confirmed that the guide wire 905 iscorrectly inserted into the pancreatic duct or the bile duct, and theoperation for pulling out the catheter 904 from the therapeuticinstrument insertion channel of the endoscope 901 is carried out whilegripping the base end side of the guide wire 905 by hand as shown inFIG. 114A. During this operation, as shown in FIG. 114B, when the endportion 904 a of the catheter 904 protrudes from a channel openingportion 907 on an operation portion 906 side of the endoscope 901, theguide wire 905 in the vicinity of the channel opening portion 907 of theendoscope 901 is gripped, and the catheter 904 is completely pulled outof the endoscope 901.

Subsequently, the base end side of the guide wire 905 is inserted intoan insertion hole of another therapeutic instrument, and thistherapeutic instrument is inserted into the therapeutic instrumentinsertion channel of the endoscope 901 so as to be guided by the guidewire 905. Thereafter, the above-described operation is repeated inaccordance with a number of times of replacement of the therapeuticinstrument.

The therapeutic instrument used for such treatment is generally set tohave a length which is not less than 190 cm by taking a length of theendoscope 901 into consideration.

Furthermore, since a length which exceeds a combination of a length ofthe endoscope 901 and that of the therapeutic instrument is required forthe guide wire 905, at least approximately 400 cm is necessary.

Moreover, for example, U.S. Pat. No. 5,921,971 discloses a bile ductcatheter which can be rapidly replaced by providing an opening portionin the longitudinal direction between an end portion of a guide wirelumen and a base end portion in a catheter shaft.

Meanwhile, in case of observing/treating the pancreaticobiliary ductsystem by using the endoscope 901, when a therapeutic instrument such asthe catheter 904 is inserted into the therapeutic instrument insertionchannel of the endoscope 901 and used, the guide wire 905 is insertedinto the therapeutic instrument. Therefore, when the therapeuticinstrument is moved with respect to the endoscope 901, the guide wire905 also simultaneously moves. Thus, for example, when replacing thetherapeutic instrument with the guide wire 905 as a guide in the statewhere the end of the guide wire 905 is inserted into the papilla, theguide wire 905 must be constantly gripped on the operation portion 906side of the endoscope 901 in order to maintain the end of the guide wire905 being inserted into the papilla.

In addition, during use of the conventional endoscope 901, it isnecessary to simultaneously carry out the two operations, i.e., pullingout the therapeutic instrument with respect to the therapeuticinstrument insertion channel of the endoscope 901 while inserting theguide wire 905 by the same amount in the operation for replacing thetherapeutic instrument, or similarly inserting the therapeuticinstrument into the therapeutic instrument insertion channel whilepulling out the guide wire 905 by the same movement amount. Therefore,that operation is complicated and troublesome.

Additionally, since the guide wire 905 has a length of approximately 400cm, it is difficult to handle the guide wire 905 in such a manner thatthe guide wire 905 does not come into contact with an unclean area suchas the floor in a small endoscope room.

Further, since the therapeutic instrument can not be replaced unless theentire length of the guide wire 905 is moved, the time required forreplacement of the therapeutic instrument itself may possibly beprolonged. Therefore, there is a drawback that the operation forreplacing the therapeutic instrument takes longer.

Furthermore, it is difficult for one operator to carry out the operationfor replacing the therapeutic instrument, and at least two assistantsare required in an operating room. Therefore, there occurs a problemthat the personnel cost increases and the pecuniary burden on a hospitalor a patient thereby increases.

Moreover, as in U.S. Pat. No. 5,921,971, in the case of the catheterhaving the opening portion in the longitudinal direction being providedbetween the end portion and the base end portion of the guide wire lumenin the catheter shaft, the operation for providing the opening portionin the longitudinal direction to the conventional contrasting catheter.Thus, there is a drawback that the manufacturing cost is higher thanthat of the conventional contrasting catheter.

In addition, an outside diameter of the shaft must be increased in orderto compensate for a reduction in rigidity of the catheter shaft causeddue to provision of a slit, or a material of the shaft must be hardened.Therefore, an increase in diameter of the shaft may possibly lead todeterioration of the working property of an operator since the insertionability in the channel of the endoscope is degraded.

Additionally, since the treatment for the pancreaticobiliary duct systemrequires specialist techniques, preference of the operator with respectto therapeutic instruments is divided in particular. Further, changingthe therapeutic instruments depending on conditions of a patient isfrequently carried out. However, usable therapeutic instruments arerestricted in this prior art by itself, and the selection range of theoperator is disadvantageously lost.

In view of the above-described problems, it is an object of the presentinvention to provide an endoscope apparatus by which a therapeuticinstrument can be replaced in a shorter time and the replacementoperation can be performed by one operator without impairing theconventional operation method of a therapeutic instrument or theoperation sense.

BRIEF SUMMARY OF THE INVENTION

According to the present invention, there is provided an endoscope inwhich a therapeutic instrument insertion channel is provided in aninsertion portion which is inserted into a celom and an end openingportion of the therapeutic instrument insertion channel is arranged inthe vicinity of an end of the insertion portion, wherein, wheninserting/removing a therapeutic instrument traveling on a guide wirewith an end portion of the guide wire inserted through the therapeuticinstrument insertion channel being led out from the end opening portionof the therapeutic instrument insertion channel, guide wire fixing meansfor releasably engaging the guide wire is provided in the vicinity ofthe end portion of the insertion portion.

Further, according to the present invention, there is provided anendoscope comprising: an insertion portion inserted into a celom; anoperation portion connected to an end portion of the insertion portionon a front side; and a therapeutic instrument elevator base which isarranged at an end portion of the insertion portion and can be operatedby the operation portion, wherein a slit enabling engagement of only aguide wire by raising the guide wire by operating the therapeuticinstrument elevator base is provided at a top portion on a guide planeof the therapeutic instrument elevator base.

Furthermore, according to the present invention, there is provided anendoscope system comprising: an endoscope in which a therapeuticinstrument insertion channel is provided in an insertion portioninserted into a celom and an end opening portion of the therapeuticinstrument insertion channel is provided in the vicinity of an end ofthe insertion portion and a therapeutic instrument insertion port as anopening portion of the therapeutic instrument insertion channel isprovided on a front side of the operation portion; a guide wire whichcan pass through the therapeutic instrument insertion channel; and atherapeutic instrument which has a duct through which the guide wire canbe inserted and which can be inserted through the therapeutic instrumentinsertion channel, wherein the therapeutic instrument has a protrusionlength from the end opening portion which is required for the treatmentin the state where the therapeutic instrument is inserted into thetherapeutic instrument insertion channel and a protrusion length fromthe therapeutic instrument insertion port required for the operation onthe front side, guide wire fixing means which releasably engaging theguide wire when inserting/removing the therapeutic instrument travelingon the guide wire with an end portion of the guide wire inserted throughthe therapeutic instrument insertion channel being led out from the endopening portion is provided in the vicinity of the end portion of theinsertion portion, and the guide wire pulls the therapeutic instrumentend portion toward the operation portion front side from a position ofthe engagement and has a length protruding from the end portion of thetherapeutic instrument on the front side when being engaged by the guidewire fixing means.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING

FIG. 1 is a perspective view showing a schematic structure of an entiresystem of an endoscope apparatus in which an endoscope and various kindsof external devices are incorporated according to a first embodiment ofthe present invention;

FIG. 2 is a vertical cross-sectional view showing a primary part of aninner structure of an end portion of an insertion portion in theendoscope according to the first embodiment;

FIG. 3 is a plane view showing a primary part of an elevator baseactuation mechanism included in an operation portion in the endoscopeaccording to the first embodiment;

FIG. 4 is a vertical cross-sectional view showing a primary part of theelevator base actuation mechanism included in the operation portion inthe endoscope according to the first embodiment;

FIG. 5 is a vertical cross-sectional view showing a primary part of theinner structure of the end portion of the insertion portion in theendoscope according to the first embodiment;

FIG. 6A is a vertical cross-sectional view of a primary part showing theengagement state of a guide wire in the endoscope according to the firstembodiment;

FIG. 6B is a front view of a therapeutic instrument elevator base in theendoscope according to the first embodiment;

FIG. 7A is a perspective view of a primary part showing a schematicstructure of an end portion of an insertion portion in an endoscopeaccording to a second embodiment of the present invention;

FIG. 7B is a plane view showing the end portion of the insertion portionin the endoscope according to the second embodiment;

FIG. 7C is a vertical cross-sectional view of a primary part showing thestate in which a guide wire in the endoscope is moved to an engagementposition according to the second embodiment;

FIG. 7D is a vertical cross-sectional view of a primary part showing amodification of the first and second embodiments;

FIG. 8A is a cross-sectional view of a primary part showing a schematicstructure of an end portion of an insertion portion in an endoscopeaccording to a third embodiment of the present invention;

FIG. 8B is a plane view of the end portion of the insertion portion inthe endoscope according to the third embodiment;

FIG. 8C is a plane view of the end portion of the insertion portionshowing the state in which the guide wire in the endoscope is moved toan engagement position according to the third embodiment;

FIG. 9 is a front view showing a therapeutic instrument elevator baseaccording to a fourth embodiment of the present invention;

FIG. 10A is a front view of a therapeutic instrument elevator base in anendoscope according to a fifth embodiment of the present invention;

FIG. 10B is a vertical cross-sectional view of the therapeuticinstrument elevator base in the endoscope according to the fifthembodiment;

FIG. 11A is a rear view of a therapeutic instrument elevator base in anendoscope according to a sixth embodiment of the present invention;

FIG. 11B is an enlarged vertical cross-sectional view showing a wireengagement groove of the therapeutic instrument elevator base in theendoscope according to the sixth embodiment;

FIG. 12A is a front view showing a first modification of the therapeuticinstrument elevator base according to the sixth embodiment;

FIG. 12B is a front view showing a second modification of thetherapeutic instrument elevator base according to the sixth embodiment;

FIG. 12C is a vertical cross-sectional view of a primary part showing athird modification of the therapeutic instrument elevator base accordingto the sixth embodiment;

FIG. 13 is a vertical cross-sectional view of a primary part showing theset-down state of the therapeutic instrument elevator base with a guidecatheter being inserted in an endoscope according to a seventhembodiment of the present invention;

FIG. 14 is a vertical cross-sectional view of a primary part showing theset-up state of the therapeutic instrument elevator base according tothe seventh embodiment;

FIG. 15A is a front view of the therapeutic instrument elevator baseaccording to the seventh embodiment;

FIG. 15B is a rear view of the therapeutic instrument elevator baseaccording to the seventh embodiment;

FIG. 16 is a vertical cross-sectional view of a primary part showing astructure of a therapeutic instrument elevator base of an endoscopeaccording to an eighth embodiment of the present invention;

FIG. 17 is a vertical cross-sectional view of a primary part showing anideal guide wire fixed state in the therapeutic instrument elevator basein the endoscope according to the eighth embodiment;

FIG. 18 is a vertical cross-sectional view showing the guide wire fixedstate when irregularities occurred due to processing in the therapeuticinstrument elevator base in the endoscope according to the eighthembodiment;

FIG. 19 is a vertical cross-sectional view of a primary part showing aguide wire fixed state according to a ninth embodiment of the presentinvention;

FIG. 20 is a vertical cross-sectional view showing the state when aguide wire is fixed at an end portion of a conventional endoscope;

FIG. 21 is a plane view of a primary part of an elevator base actuationmechanism showing an 11th embodiment according to the present invention;

FIG. 22A is a vertical cross-sectional view of the elevator baseactuation mechanism according to the 11th embodiment;

FIG. 22B is a perspective view of a primary part showing an elevatorbase operation knob of the elevator base actuation mechanism accordingto the 11th embodiment;

FIG. 22C is a perspective view showing a deterrence reinforcement memberof a braking mechanism of the elevator base actuation mechanismaccording to the 11th embodiment;

FIG. 22D is a plane view of the deterrence reinforcement member showingthe embedded state of a friction resistance member of the elevator baseactuation mechanism according to the 11th embodiment;

FIG. 23 is a plane view showing a deterrence reinforcement member of abraking mechanism in a first modification of the 11th embodiment;

FIG. 24 is a plane view of a primary part of an elevator base actuationmechanism showing a tenth embodiment according to the present invention;

FIG. 25A is a vertical cross-sectional view of the elevator baseactuation mechanism showing the tenth embodiment;

FIG. 25B is a vertical cross-sectional view of a primary part showingthe state in which an operation lever of the set-up actuation mechanismof the elevator base actuation mechanism according to the tenthembodiment is elastically deformed;

FIG. 26 is a perspective view showing a stopper member of the elevatorbase actuation mechanism according to the tenth embodiment;

FIG. 27 is an explanatory view for explaining the operation of theelevator base actuation mechanism according to the tenth embodiment;

FIG. 28 is a vertical cross-sectional view of a primary part showing amodification of the tenth embodiment;

FIG. 29A is a perspective view showing an end portion of an insertionportion of an endoscope according to a 12th embodiment of the presentinvention;

FIG. 29B is a plane view showing an actual endoscopic screen when aguide wire of the endoscope is fixed according to the 12th embodiment;

FIG. 30 is a vertical cross-sectional view showing an inner structure ofan end portion in the insertion portion of the endoscope according tothe 12th embodiment;

FIG. 31A is a plane view showing a guide wire according to a 13thembodiment of the present invention;

FIG. 31B is a plane view showing a first modification of the guide wireaccording to the 13th embodiment;

FIG. 31C is a plane view showing a second modification of the guide wireaccording to the 13th embodiment;

FIG. 32A is a vertical cross-sectional view of a primary part showingthe set-down state of a therapeutic instrument elevator base when aguide wire is fixed according to a 14th embodiment of the presentinvention;

FIG. 32B is a vertical cross-sectional view of a primary part showingthe set-down state of a therapeutic instrument elevator base when aconventional guide wire is fixed;

FIG. 33A is a perspective view of a primary part showing a schematicstructure of an end portion of an insertion portion in an endoscopeaccording to a 15th embodiment of the present invention;

FIG. 33B is a vertical cross-sectional view of a primary part showingthe inner structure of an end portion of an insertion section in theendoscope according to the 15th embodiment;

FIG. 34 is a perspective view of a primary part showing a modificationof an end cover of the insertion portion in the endoscope according tothe 15th embodiment;

FIG. 35A is a horizontal cross-sectional view showing the set-down stateof a therapeutic instrument elevator base seen from an end portion of anendoscope according to a 16th embodiment of the present invention;

FIG. 35B is a horizontal cross-sectional view showing the state in whichthe therapeutic instrument elevator base is raised in the endoscopeaccording to the 16th embodiment;

FIG. 36A is a horizontal cross-sectional view showing the set-down stateof a therapeutic instrument elevator base seen from an end portion of anendoscope according to a 17th embodiment of the present invention;

FIG. 36B is a horizontal cross-sectional view showing the state in whichthe therapeutic instrument elevator base is raised in the endoscopeaccording to the 17th embodiment;

FIG. 37A is a plane view showing an end portion of an insertion portionin an endoscope according to an 18th embodiment of the presentinvention;

FIG. 37B is a vertical cross-sectional view of a primary part showingthe inner structure of the end portion of the insertion portion in theendoscope according to the 18th embodiment;

FIG. 37C is a vertical cross-sectional view of a primary part showingthe state before fixing a guide wire in the endoscope according to the18th embodiment;

FIG. 37D is a vertical cross-sectional view of a primary state showingthe state in which the guide wire is fixed in the endoscope according tothe 18th embodiment;

FIG. 38 is a vertical cross-sectional view of a primary part showing aninner structure of an end portion of an insertion portion in anendoscope according to a 19th embodiment of the present invention;

FIG. 39 is a perspective view showing a therapeutic instrument elevatorbase in the endoscope according to the 19th embodiment;

FIG. 40 is a vertical cross-sectional view of a primary part showing theengagement state of a guide wire in an endoscope according to a 20thembodiment of the present invention;

FIG. 41A is a perspective view showing a schematic structure of an endportion of an insertion portion in an endoscope according to a 21stembodiment of the present invention;

FIG. 41B is a perspective view showing a guide wire fixture in theendoscope according to the 21st embodiment;

FIG. 42 is a vertical cross-sectional view showing the set-down state ofa therapeutic instrument elevator base according to a 22nd embodiment ofthe present invention;

FIG. 43 is a vertical cross-sectional view showing the set-up state ofthe therapeutic instrument elevator base according to the 22ndembodiment;

FIG. 44 is a horizontal cross-sectional view of a primary part showingan inner structure of an end portion in an insertion portion in theendoscope according to the 22nd embodiment;

FIG. 45 is a schematic block diagram of an endoscope showing a 23rdembodiment of the present invention;

FIG. 46A is a perspective view of a primary part showing the state inwhich a guide wire fixture is held in a standby position in an endoscopeaccording to a 24th embodiment;

FIG. 46B is a perspective view of a primary part showing a fixed stateof a guide wire;

FIG. 47A is a perspective view of a primary part showing the state inwhich a guide wire fixture is held at a standby position in an endoscopeaccording to a 25th embodiment of the present invention;

FIG. 47B is a perspective view of a primary part showing the fixed stateof the guide wire;

FIG. 48 is a plane view of an end portion of an insertion portion in anendoscope according to a 26th embodiment of the present invention;

FIG. 49 is a vertical cross-sectional view of a primary part showing thestate in which a guide wire fixture is held at a standby position in theendoscope according to the 26th embodiment;

FIG. 50 is a vertical cross-sectional view of a primary part showing thefixed state of the guide wire by the guide wire fixture in the endoscopeaccording to the 26th embodiment;

FIG. 51 is a perspective view of a primary part showing a secondmodification according to the 11th embodiment;

FIG. 52 is a schematic block diagram of a primary part showing a 27thembodiment of the present invention;

FIG. 53 is a vertical cross-sectional view showing an inner structure ofan end portion in the endoscope according to the 27th embodiment;

FIG. 54A is a perspective view showing a guide wire engagement memberaccording to the 27th embodiment;

FIG. 54B is a perspective view showing a rack gear at an end of a towwire in the endoscope according to the 27th embodiment;

FIG. 55 is a perspective view showing a modification of the guide wireengagement member in the 27th embodiment;

FIG. 56A is a vertical cross-sectional view of a primary part showing aninner structure of an end portion of an insertion portion in anendoscope according to a 28th embodiment of the present invention;

FIG. 56B is a perspective view showing a guide wire engagement member inthe endoscope according to the 28th embodiment;

FIG. 57A is a vertical cross-sectional view of a primary part showing aninner structure of an end portion of an insertion portion in anendoscope according to a 29th embodiment of the present invention;

FIG. 57B is a vertical cross-sectional view of a primary part showingthe state in which a guide wire fixing elevator base of an elevator baseactuation mechanism is held at a standby position in the endoscopeaccording to the 29th embodiment;

FIG. 57C is a vertical cross-sectional view of a primary part showingthe state in which the guide wire fixing elevator base of the elevatorbase actuation mechanism is moved to an engagement position of the guidewire in the endoscope according to the 29th embodiment;

FIG. 58A is a perspective view showing a guide wire fixing elevator baseof a therapeutic instrument elevator base according to a 30th embodimentof the present invention;

FIG. 58B is a perspective view showing a reception portion of thetherapeutic instrument elevator base according to the 30th embodiment;

FIG. 58C is a perspective view showing a guide wire fixing elevator baseaccording to the 30th embodiment;

FIG. 59A is a perspective view showing a modification of the guide wirefixing elevator base in the endoscope according to the 29th embodiment;

FIG. 59B is a perspective view showing a second modification of theguide wire fixing elevator base;

FIG. 60A is a vertical cross-sectional view of a primary part showingthe state in which a guide wire fixing elevator base of an elevator baseactuation mechanism is held at a standby position according to a 31stembodiment of the present invention;

FIG. 60B is a vertical cross-sectional view of a primary part showingthe state in which the guide wire fixing elevator base of the elevatorbase actuation mechanism is moved to an engagement position of a guidewire;

FIG. 61A is a perspective view showing the guide wire fixing elevatorbase on a therapeutic instrument elevator base in the endoscopeaccording to the 31st embodiment;

FIG. 61B is a perspective view showing the operation state of the guidewire fixing elevator base of the elevator base actuation mechanism inthe endoscope according to the 31st embodiment;

FIG. 62 is a relational view showing the relationship between a set-upangle of the therapeutic instrument elevator base and a set-up angle ofthe guide wire fixing elevator base in the endoscope according to the31st embodiment;

FIG. 63 is a perspective view showing a modification of the guide wirefixing elevator base in the endoscope according to the 31st embodiment;

FIG. 64 is a perspective view of an end portion of an insertion portionin an endoscope according to a 32nd embodiment of the present invention;

FIG. 65 is a vertical cross-sectional view of a primary part showing thestate in which a guide wire fixing elevator base of an elevator baseactuation mechanism is moved to an engagement position of a guide wireaccording to the 32nd embodiment;

FIG. 66A is a plane view showing an operation portion of an endoscopeaccording to a 33rd embodiment of the present invention;

FIG. 66B is a plane view showing an insertion portion of the endoscopeaccording to the 33rd embodiment;

FIG. 66C is a vertical cross-sectional view of a primary part showing aninner structure of the insertion portion of the endoscope according tothe 33rd embodiment;

FIG. 66D is a perspective view showing a cam member in the endoscopeaccording to the 33rd embodiment;

FIG. 67A is a plane view showing a first modification of an operationportion in the endoscope according to the 33rd embodiment;

FIG. 67B is a plane view showing a second modification of the operationportion in the endoscope according to the 33rd embodiment;

FIG. 68A is a vertical cross-sectional view of a primary part showing aninner structure of an end portion of an insertion portion in anendoscope according to a 34th embodiment of the present invention;

FIG. 68B is a vertical cross-section of a primary part showing theoperation state of a guide wire fixture in the endoscope according tothe 34th embodiment;

FIG. 69A is a vertical cross-sectional view of a primary part showing aninner structure of an end portion of an insertion portion in anendoscope according to a 35th embodiment of the present invention;

FIG. 69B is a vertical cross-sectional view of a primary part showingthe operation state of a guide wire fixture in the endoscope accordingto the 35th embodiment;

FIG. 69C is a perspective view showing a torque transmission member inthe endoscope according to the 35th embodiment;

FIG. 70A is a perspective view of a primary part showing a schematicstructure of an end portion of an insertion portion in an endoscopeaccording to a 36th embodiment of the present invention;

FIG. 70B is a vertical cross-sectional view of a primary part showing aninner structure of the end portion of the insertion portion in theendoscope according to the 36th embodiment;

FIG. 70C is a vertical cross-sectional view of a primary part showing astate in which a guide wire fixing elevator base is moved to anengagement position of a guide wire in the endoscope according to the36th embodiment;

FIG. 71 is a plane view of a primary part showing a state in which aguide wire fixing portion is held at a standby position in an endoscopeaccording to a 37th embodiment of the present invention;

FIG. 72 is a plane view of a primary part showing a fixed state of aguide wire in the endoscope according to the 37th embodiment;

FIG. 73 is a plane view showing a modification of a fixed state of anend portion of the guide wire fixing portion in the endoscope accordingto the 37th embodiment;

FIG. 74A is a perspective view of a primary part showing a schematicstructure of an end portion of an insertion portion in an endoscopeaccording to a 38th embodiment of the present invention;

FIG. 74B is a perspective view of a primary part showing a structure ofa guide wire fixture in the endoscope according to the 38th embodiment;

FIG. 74C is a vertical cross-sectional view of a primary part showingthe structure of the guide wire fixture in the endoscope according tothe 38th embodiment;

FIG. 75 is a vertical cross-sectional view of a primary part showing amodification of the endoscope according to the 38th embodiment;

FIG. 76 is a perspective view showing an operation portion on the frontside in an endoscope according to a 39th embodiment of the presentinvention;

FIG. 77A is a perspective view showing the state before fixing the guidewire in the endoscope according to the 39th embodiment;

FIG. 77B is a perspective view showing the state after fixing the guidewire in the endoscope according to the 39th embodiment;

FIG. 78 is a vertical cross-sectional view showing the inner structureof the end portion of the insertion portion in the endoscope accordingto the 39th embodiment;

FIG. 79A is a perspective view showing the state in which a snare isclosed according to the 39th embodiment;

FIG. 79B is a perspective view showing the state in which the snare isopened in the endoscope according to the 39th embodiment;

FIG. 80 is an exploded perspective view showing a guide wire fixingmember according to the 39th embodiment;

FIG. 81 is a perspective view showing the state in which a guide wirefixing member is attached to an end portion of an insertion portion ofan endoscope in an endoscope apparatus according to a 40th embodiment ofthe present invention;

FIG. 82 is a perspective view showing the structure of the guide wirefixing member in the endoscope apparatus according to the 40thembodiment;

FIG. 83A is a perspective view showing the state before a therapeuticinstrument elevator base is raised when raising a therapeutic instrumentother than a guide wire by using a guide wire fixing member in theendoscope apparatus according to the 40th embodiment;

FIG. 83B is a perspective view showing the state in which thetherapeutic instrument elevator base is raised in the endoscopeapparatus according to the 40th embodiment;

FIG. 84A is a perspective view showing the state before the therapeuticinstrument elevator base is raised when raising the guide wire by usingthe guide wire fixing member in the endoscope apparatus according to the40th embodiment;

FIG. 84B is a perspective view showing the state in which thetherapeutic instrument elevator base is raised in the endoscopeapparatus according to the 40th embodiment;

FIG. 85 is a vertical cross-sectional view of a primary part showing thestate in which the guide wire is engaged by using the guide wire fixingmember in the endoscope apparatus according to the 40th embodiment;

FIG. 86A is a perspective view of a primary part showing the structureof a guide wire fixing member according to a 41st embodiment of thepresent invention;

FIG. 86B is a plane view showing an attachment portion of the guide wirefixing member according to the 41st embodiment;

FIG. 87A is a vertical cross-sectional view of a primary part showing anattachment mechanism for the guide wire fixing member in the statebefore attaching the guide wire fixing member to the end portion of theinsertion portion of the endoscope in the endoscope apparatus accordingto the 41st embodiment;

FIG. 87B is a vertical cross-sectional view of a primary art showing thestate in which the guide wire fixing member is attached to the endportion of the insertion portion of the endoscope in the endoscopeapparatus according to the 41st embodiment;

FIG. 88A is a perspective view showing the state before a therapeuticinstrument elevator base is raised when raising a therapeutic instrumentother than a guide wire by using the guide wire fixing member in theendoscope apparatus according to the 41st embodiment;

FIG. 88B is a perspective view showing the state in which thetherapeutic instrument elevator base is raised in the endoscopeapparatus according to the 41st embodiment;

FIG. 89A is a perspective view showing the state before the therapeuticinstrument elevator base is raised when raising the guide wire by usingthe guide wire fixing member in the endoscope apparatus according to the41st embodiment;

FIG. 89B is a perspective view showing the state in which thetherapeutic instrument elevator base is raised in the endoscopeapparatus according to the 41st embodiment;

FIG. 90 is a plane view of a primary part showing the state in which aguide wire fixing member is attached to an end portion of an insertionportion of an endoscope in an endoscope apparatus according to a 42ndembodiment of the present invention;

FIG. 91 is a plane view of a primary part showing an attachmentmechanism of the guide wire fixing member in the endoscope apparatusaccording to the 42nd embodiment;

FIG. 92A is a plane view of a primary part showing an attachmentmechanism of the guide wire fixing member in the endoscope apparatusaccording to the 42nd embodiment;

FIG. 92B is an explanatory view for explaining the state in which theendoscope apparatus according to the 42nd embodiment is inserted into acelom;

FIG. 93A is a plane view of a primary part showing a guide wire fixingmember main body having a guide wire identification mechanism portionand a click mechanism in the endoscope apparatus according to the 42ndembodiment;

FIG. 93B is a side view of the guide wire fixing member main body in theendoscope apparatus according to the 42nd embodiment;

FIG. 93C is a plane view showing a back surface of the guide wire fixingmechanism portion in the endoscope apparatus according to the 42ndembodiment;

FIG. 93D is a side view of the guide wire fixing mechanism portion inthe endoscope apparatus according to the 42nd embodiment;

FIG. 94A is a plane view of a front surface side of the guide wirefixing member main body in the endoscope apparatus according to the 42ndembodiment;

FIG. 94B is a plane view of a back surface side of a base member in theendoscope apparatus according to the 42nd embodiment;

FIG. 94C is a side view of the base member in the endoscope apparatusaccording to the 42nd embodiment;

FIG. 95A is a plane view of a guide wire fixture in the endoscopeapparatus according to the 42nd embodiment;

FIG. 95B is a plane view of a guide wire identification member in theendoscope apparatus according to the 42nd embodiment;

FIG. 95C is a side view of a guide wire identification member in theendoscope apparatus according to the 42nd embodiment;

FIG. 95D is a side view of a stopper in the endoscope apparatusaccording to the 42nd embodiment;

FIG. 95E is a plane view of the stopper in the endoscope apparatusaccording to the 42nd embodiment;

FIG. 96 is a plane view of a top cover arranged on a front surface sideof a base member of the guide wire fixing member main body in theendoscope apparatus according to the 42nd embodiment;

FIG. 97A is a side view showing an attachment member of the guide wirefixing member in the endoscope apparatus according to the 42ndembodiment;

FIG. 97B is a plane view showing an attachment member of the guide wirefixing member in the endoscope apparatus according to the 42ndembodiment;

FIG. 98A is a view showing a click pin of the click mechanism of theguide wire fixing member in the endoscope apparatus according to the42nd embodiment;

FIG. 98B is a view showing a click groove in the endoscope apparatusaccording to the 42nd embodiment;

FIG. 99A is a plane view showing an initial state of the guide wirefixing member in the endoscope apparatus according to the 42ndembodiment;

FIG. 99B is a side view of the guide wire fixing member in the endoscopeapparatus according to the 42nd embodiment;

FIG. 99C is a plane view showing the state in which a stopper releasingportion of a guide wire identification member has pushed open a stoppermember in the horizontal direction in the endoscope apparatus accordingto the 42nd embodiment;

FIG. 99D is a plane view showing the state in which the stopper isreleased and the guide wire fixture is thrusted down in the endoscopeapparatus according to the 42nd embodiment;

FIG. 100A is a plane view showing the state in which the guide sirefixture and the guide wire identification member are held in thethrusted state in the endoscope apparatus according to the 42ndembodiment;

FIG. 100B is a plane view showing the state in which a click pin reachesa second convex portion and the locked state is released;

FIG. 100C is a plane view showing the state in which the guide wirefixture in process of returning to the initial state;

FIG. 101A is a plane view of an end portion of an insertion portionshowing the state before the therapeutic instrument elevator base israised when raising the therapeutic instrument in the endoscopeapparatus according to the 42nd embodiment;

FIG. 101B is a vertical cross-sectional view of an end portion of aninsertion portion showing the state before the therapeutic instrumentelevator base is raised when raising the therapeutic instrument in theendoscope apparatus according to the 42nd embodiment;

FIG. 101C is a plane view of an end portion of an insertion portionshowing the state in which the therapeutic instrument elevator base israised and the stopper is released;

FIG. 101D is a vertical cross-sectional view of the end portion of theinsertion portion showing the state before the therapeutic instrumentelevator base is raised when raising the therapeutic instrument in theendoscope apparatus according to the 42nd embodiment;

FIG. 101E is a plane view of an end portion of an insertion portionshowing the state in which the guide wire fixture and the guide wireidentification member are thrusted down according to the 42ndembodiment;

FIG. 101F is a vertical cross-sectional view of the end portion of theinsertion portion showing the state in which the guide wire fixture andthe guide wire identification member are thrusted down according to the42nd embodiment;

FIG. 102A is a plane view of the end portion of the insertion portionshowing the state before the therapeutic instrument elevator base israised when raising the guide wire in the endoscope apparatus accordingto the 42nd embodiment;

FIG. 102B is a vertical cross-sectional view of the end portion of theinsertion portion showing the state before the therapeutic instrumentelevator base is raised when raising the guide wire in the endoscopeapparatus according to the 42nd embodiment;

FIG. 102C is a plane view of the end portion of the insertion portionshowing the state in which the guide wire is pressed against and fixedto the therapeutic instrument elevator base and the guide wire fixturein the endoscope apparatus according to the 42nd embodiment;

FIG. 102D is a vertical cross-sectional view of the end portion of theinsertion portion showing the state before the therapeutic instrumentelevator base is raised when raising the guide wire in the endoscopeapparatus according to the 42nd embodiment;

FIG. 103A is a plane view of a front surface side of a base member in aguide wire fixing portion main body according to a 43rd embodiment ofthe present-invention;

FIG. 103B is a plane view of a back surface side of the base member inthe guide wire fixing member main body according to the 43rd embodiment;

FIG. 103C is a side view of the base member of the guide wire fixingmember main body according to the 43rd embodiment;

FIG. 103D is a plane view of a guide wire fixture according to the 43rdembodiment;

FIG. 103E is a plane view of a guide wire identification memberaccording to the 43rd embodiment;

FIG. 103F is a side view of the guide wire identification memberaccording to the 43rd embodiment;

FIG. 103G is a plane view of a stopper member according to the 43rdembodiment;

FIG. 103H is a side view of the stopper member according to the 43rdembodiment;

FIG. 103I is a plane view of a click pin of a click mechanism accordingto the 43rd embodiment;

FIG. 103J is a view showing a click groove of the click mechanismaccording to the 43rd embodiment;

FIG. 104A is a plane view showing the initial state before a therapeuticinstrument elevator base is raised in the operation of a guide wirefixing member main body when raising a therapeutic instrument in theendoscope apparatus according to the 43rd embodiment;

FIG. 104B is a vertical cross-sectional view showing the initial statebefore the therapeutic instrument elevator base is raised in theoperation of the guide wire fixing member main body when raising thetherapeutic instrument in the endoscope apparatus according to the 43rdembodiment;

FIG. 104C is a plane view showing the state in which the therapeuticinstrument elevator base is raised and a stopper is released in theendoscope apparatus according to the 43rd embodiment;

FIG. 104D is a vertical cross-sectional view in the endoscope apparatusaccording to the 43rd embodiment;

FIG. 104E is a plane view showing the state in which a guide wirefixture and the guide wire identification member are thrusted down inthe endoscope apparatus according to the 43rd embodiment;

FIG. 104F is a vertical cross-sectional view showing the state in whichthe guide wire fixture and the guide wire identification member arethrusted down in the endoscope apparatus according to the 43rdembodiment;

FIG. 105A is a plane view showing the click releasing state of the guidewire fixture and the guide wire identification member in the endoscopeapparatus according to the 43rd embodiment;

FIG. 105B is a vertical cross-sectional view showing the click releasingstate of the guide wire fixture and the guide wire identification memberin the endoscope apparatus according to the 43rd embodiment;

FIG. 105C is a plane view showing the state in which the guide wirefixture and the guide wire identification member return to initialpositions in the endoscope apparatus according to the 43rd embodiment;

FIG. 105D is a vertical cross-sectional view showing the state in whichthe guide wire fixture and the guide wire identification member returnto the initial positions in the endoscope apparatus according to the43rd embodiment;

FIG. 106A is a plane view of the end portion of the insertion portionshowing the state before the therapeutic instrument elevator base israised in the endoscope apparatus according to the 43rd embodiment;

FIG. 106B is a vertical cross-sectional view of the end portion of theinsertion portion showing the state before the therapeutic instrumentelevator base is raised in the endoscope apparatus according to the 43rdembodiment;

FIG. 106C is a plane view of the end portion of the insertion portionshowing the state in which the therapeutic instrument elevator base israised and the stopper is released in the endoscope apparatus accordingto the 43rd embodiment;

FIG. 106D is a vertical cross-sectional view of the end portion of theinsertion portion showing the state in which the therapeutic instrumentelevator base is raised and the stopper is released in the endoscopeapparatus according to the 43rd embodiment;

FIG. 106E is a plane view of the end portion of the insertion portionshowing the state in which the guide sire fixture and the guide wireidentification member are thrusted down;

FIG. 106F is a vertical cross-sectional view of the end portion of theinsertion portion showing the state in which the guide wire fixture andthe guide wire identification member are thrusted down;

FIG. 107A is a plane view of the end portion of the insertion portionshowing the state before the therapeutic instrument elevator base israised when the guide wire is raised in the endoscope apparatusaccording to the 43rd embodiment;

FIG. 107B is a vertical cross-sectional view of the end portion of theinsertion portion showing the state before the therapeutic instrumentelevator base is raised when the guide wire is raised in the endoscopeapparatus according to the 43rd embodiment;

FIG. 107C is a plane view of the end portion of the insertion portionshowing the state in which the guide wire is pressed against and fixedto the therapeutic instrument elevator base and the guide wire fixture;

FIG. 107D is a vertical cross-sectional view of the end portion of theinsertion portion showing the state before the therapeutic instrumentelevator base is raised according to the 43rd embodiment;

FIG. 108A is a perspective view of a primary part showing the state inwhich a gripping therapeutic instrument is inserted into an externalchannel according to a 44th embodiment of the present invention;

FIG. 108B is a perspective view of a primary part showing the state inwhich a snare in the gripping therapeutic instrument is inserted intothe external channel according to the 44th embodiment;

FIG. 108C is a perspective view of a primary part showing the state inwhich a guide wire thrusting plate in the gripping therapeuticinstrument is inserted into the external channel according to the 44thembodiment;

FIG. 108D is a perspective view of a primary part showing non-slipzigzag grooves of a contact surface of an arm portion of the grippingtherapeutic instrument shown in FIG. 108A with the guide wire;

FIG. 108E is a perspective view of a primary part showing the state inwhich resin such as rubber is applied to a contact surface of the armportion of the gripping therapeutic instrument shown in FIG. 108C withthe guide wire;

FIG. 109 is a perspective view of a primary part showing the attachmentstate of a guide wire fixing member in an endoscope apparatus accordingto a 45th embodiment of the present invention;

FIG. 110A is a perspective view of a primary part showing the state inwhich a gripping therapeutic instrument is attached to an end portion ofan insertion portion in an endoscope according to a 46th embodiment ofthe present invention;

FIG. 110B is a perspective view of a primary part showing the state inwhich a bending portion of the endoscope according to the 46thembodiment is curved to relax an operation wire;

FIG. 110C is a perspective view of a primary part showing the state inwhich a guide wire is raised to a position at which it can be pinched bythe gripping therapeutic instrument in the endoscope according to the46th embodiment;

FIG. 111A is a vertical cross-sectional view of a primary part showingthe set-up state of the therapeutic instrument when the guide wirefixing member is detachably attached in the vicinity of the end portionof the insertion portion of the endoscope;

FIG. 111B is a vertical cross-sectional view of a primary part showingthe state in which the guide wire is raised in place of the therapeuticinstrument shown in FIG. 111A;

FIG. 111C is a vertical cross-sectional view of a primary part showingthe set-up state of the therapeutic instrument when the guide wirefixing member is embedded in the vicinity of the end portion of theinsertion portion of the endoscope;

FIG. 111D is a vertical cross-sectional view of a primary part showingthe state in which the guide wire is raised in place of the therapeuticinstrument shown in FIG. 111A;

FIG. 112A is a plane view of a primary part showing the end portion ofthe insertion portion in an existing endoscope;

FIG. 112B is a side view of FIG. 112A;

FIG. 112C is a plane view of a primary part showing an endoscope whichhas a guide wire fixing member setting space at the end portion of theinsertion portion of the endoscope;

FIG. 112D is a side view of FIG. 112C;

FIG. 112E is a plane view of a primary part showing an endoscope havingan attachment member of a guide wire fixing mechanism portion;

FIG. 112F is a side view of FIG. 112E;

FIG. 112G is a plane view of a primary part showing an endoscope inwhich a guide wire fixing member having a guide wire fixing mechanismportion is undetachably included;

FIG. 112H is a side view of FIG. 112G;

FIG. 113A is a plane view of a primary part showing a modification of aguide wire;

FIG. 113B is a plane view of a primary part showing another modificationof the guide wire;

FIG. 113C is a plane view of a primary part showing still anothermodification of the guide wire;

FIG. 114A is an explanatory drawing for illustrating the operation statefor pulling out a catheter from a therapeutic instrument insertionchannel of an endoscope when performing endoscopic treatment by usingthe endoscope by a conventional method; and

FIG. 114B is an explanatory drawing for illustrating the operation statefor completely pulling out the catheter from the endoscope.

DETAILED DESCRIPTION OF THE INVENTION

FIGS. 1 to 6B show a first embodiment according to the presentinvention. FIG. 1 shows a schematic structure of an entire system of anendoscope apparatus in which an endoscope 1 and various kinds ofexternal devices are incorporated according to this embodiment. As theexternal devices, there are devices such as a light source device 2, animage processing device 3, a monitor 4, an input keyboard 5, a suctionpump device 6, a water supply jar 7 and others, and these devices areset in a shelf having carriers 8.

Further, to the endoscope 1 are provided an elongated insertion portion12 which is inserted into a celoma, an operation portion 13 on a frontside which is connected to a base end portion of the insertion portion12, a universal cord 14 whose base end portion is connected to theoperation portion 13. Furthermore, to the insertion portion 12 areprovided respective constituent parts including an elongated flexiblepipe portion 15 having the flexibility, a bending portion 16 connectedto an end of the flexible pipe portion 15, and an end portion 17arranged at a leading edge position of the insertion portion 12.

Moreover, a connector 18 is provided to an end portion of the universalcord 14 connected to the operation portion 13. A light guide pipe or anelectrical contact portion is provided to this connector 18. Inaddition, this connector 18 is connected to the light source device 2and the image processing device 3 as the external devices, respectively.

Additionally, as shown in FIG. 7A, a concave notch portion 17 a obtainedby notching one side surface is formed on the outer peripheral surfaceof the end portion 17 of the endoscope 1. Further, a channel openingportion 26 is arranged on one side portion of this notch portion 17 a.Furthermore, an observation optical system object lens (not shown) andan illumination optical system illumination lens (not shown) areprovided in alignment next to the channel opening portion 26.

Moreover, an air supply/water supply nozzle (not shown) protrudes on arear end wall surface 17 b of the notch portion 17 a of the end portion17. In addition, a fluid such as water or air is blown from this nozzleto the external surface of the object lens, thereby cleaning the lenssurface.

In addition, to the operation portion 13 of the endoscope 1 are provideda curving operation portion 56 for curving the bending portion 16 of theinsertion portion 12 in the vertical/horizontal direction, an airsupply/water supply button 59, and a suction operation button 60. Also,an insertion opening portion 61 which is connected to the therapeuticinstrument insertion channel 23 is provided. Additionally, the nozzle ofthe end portion 17 is caused to selectively inject the gas and theliquid by the operation of the air supply/water supply button 59.Further, the suction force is selectively caused to act on the channelopening portion 26 of the end portion 17 by the operation of the suctionoperation button 60 through the therapeutic instrument insertion channel23, thereby collecting mucin and the like in a celoma.

Furthermore, as shown in FIGS. 3 and 4, an elevator base actuationmechanism 41 for operating the set-up wire 30 is included in theoperation portion 13. A wire fixing member 42 consisting of a hardbar-like material such as a metal is integrally fixed to a base endportion of the set-up wire 30 by solder and the like. An engagementgroove 43 made up of a concave portion is formed at a base end portionof the wire fixing member 42 as shown in FIG. 4.

Moreover, a link member 44 constituted by a hard block body such as ametal is fixed to the base end portion of the wire fixing member 42. Aninsertion hole 44 a of the wire fixing member 42 is formed at the linkmember 44. In addition, the base end portion of the wire fixing member42 is fitted into the insertion hole 44 a of the link member 44. Areasof the base end portion of the wire fixing member 42 to which theengagement groove 43 is formed are all fitted in the insertion hole 44 aof the link member 44.

Additionally, a female screw portion 45 to which a fixing screw 46 ofthe wire fixing member 42 is screwed and inserted is provided to thelink member 44. Further, an end portion of the fixing screw 46 screwedto the female screw portion 45 of the link member 44 is engaged in theengagement groove 43 of the wire fixing member 42 in the inserted state.As a result, the wire fixing member 42 is connected to the link member44 in the fixed state.

Furthermore, a base 47 as a base board of the operation portion 13 isprovided inside the operation portion 13. Moreover, the link member 44is arranged in the longitudinal direction of the base 47 so as to becapable of moving back and forth.

In addition, one end portion of an arm 49 is connected to the linkmember 44 by a link shaft 50 as a bar-like shaft member so as to becapable of swiveling. An engagement member 51 consisting of a C type orE type snap ring and the like is engaged with an end portion which is onthe opposite side to the end portion of the base 47 side in the linkshaft 50.

Further, the other end portion of the arm 49 is connected to an elevatoroperation knob 48 which is provided in contiguity with the curvingoperation portion 56. Furthermore, a set-up wire 30 is pulled by theoperation of the elevator operation knob 48 in the operation portion 13through the arm 49, the link member 44 and the wire fixing member 42 insequence, and derricking motion of the therapeutic instrument elevatorbase 27 is caused around an elevator base swivel supporting point. As aresult, a guide catheter and a guide wire 68 which are inserted into thetherapeutic instrument insertion channel 23 and led to the outside fromthe channel opening portion 26 are raised by raising the therapeuticinstrument elevator base 27.

The structure of the end portion 17 of the insertion portion 12 will nowbe described in detail with reference to FIG. 2. An end hard portion 21as an end portion main body and an end cover 22 which is formed of anon-conductive material such as resin so as to surround the end hardportion 21 are provided to the end portion 17. The end cover 22 is fixedto the end hard portion 21 by an adhesive and the like.

Further, a lead-in guide path 24 for guiding leading of a therapeuticinstrument and the like to the end side is formed at the end hardportion 21. This lead-in guide path 24 is formed so as to be connectedwith the therapeutic instrument insertion channel (insertion hole) 23 asa therapeutic instrument insertion guide path provided in the insertionportion 12 of the endoscope 1.

Furthermore, to the end side of the lead-in guide path 24 is provided anaccommodation chamber 25 as a space portion formed by the end hardportion 21 and the end cover 22. Moreover, a channel opening portion 26constituting the end opening portion of the therapeutic instrumentinsertion channel 23 is formed by the opening portion of theaccommodation chamber 25.

Moreover, a therapeutic instrument elevator base 27 for raising, e.g., atherapeutic instrument led through the channel 23 or a therapeuticinstrument such as a guide catheter to a desired position is provided inthe accommodation chamber 25. One end of the therapeutic instrumentelevator base 27 is pivoted by an elevator base swivel supporting point28 provided to the end hard portion 21.

The elevator base swivel supporting point 28 is arranged at a lower partof the end opening portion of the lead-in guide path 24. In addition,the therapeutic instrument elevator base 27 is attached in theaccommodation chamber 25 with the elevator base swivel supporting pointat the center so as to be capable of a derricking motion so that thetherapeutic instrument elevator base 27 can swivel from a standbyposition indicated by solid lines shown in FIG. 2 to a therapeuticinstrument set-up position indicated by dotted lines in the samedrawing.

In addition, a guide plane 29 for guiding, e.g., a therapeuticinstrument or that such as a guide catheter is formed on the therapeuticinstrument elevator base 27. This guide plane 29 has a cross-sectionalshape which is continuous from the lead-in guide path 24 being formed bya substantially-V-shaped groove.

Additionally, an end portion of a set-up wire 30 is fixed to thetherapeutic instrument elevator base 27. This set-up wire 30 is led tothe operation portion 13 side through a guide pipe 31 and a guide tube32 inserted into the insertion portion 12, and connected to alater-described elevator base operation mechanism 41. Further, thetherapeutic instrument elevator base 27 is configured to perform thederricking motion with the elevator base swivel supporting point 28 atthe center by the towing operation of the set-up wire 30.

Furthermore, as shown in FIG. 6B, a wire engagement groove 321 having aslit-like shape is provided as guide wire fixing means on the bottom ofthe substantially-V-shaped groove in the guide plane 29 of thetherapeutic instrument elevator base. This wire engagement groove 321has two opposed wall surfaces and a width such that only the outerperiphery of the guide wire 68 is brought into contact with the walls.Moreover, the guide wire 68 is releasably engaged with the wireengagement groove in the inserted state.

Incidentally, as the wire engagement groove 321, a grove whose width isnarrowed in the tapered shape toward the bottom and which has asubstantially-V-shaped cross section is preferable. In addition, it isalso good that the relationship between an opening portion slit width(groove width) T1 of the wire engagement groove 321, a wire diameter D1of the guide wire 68 and an outside diameter D2 of the therapeuticinstrument or any other therapeutic instrument such as a catheter is setto “D1<T1<D2”.

The effect of this embodiment will now be described. When the endoscope1 according to this embodiment is used, a guide catheter is insertedinto the therapeutic instrument insertion channel 23 from the insertionopening portion 61 of the operation portion 13 of the endoscope 1.Additionally, the guide catheter is caused to protrude from the channelopening portion 26 to the outer side and inserted into apancreatic/hepatic duct (not shown) in the papillotomy manner.Thereafter, the currently used guide catheter is replaced with atherapeutic instrument which is subsequently used.

In the operation for replacing the therapeutic instrument, the guidewire 68 is first inserted from a mouth ring of the guide catheter on thebase end side. Insertion of the end portion of the guide wire 68 intothe pancreatic/hepatic duct is confirmed by an observation image(endoscopic image) of the endoscope 1, and the base end side of theguide wire 68 is gripped by hand.

Subsequently, in this state, the operation for pulling out the guidecatheter is performed, and an observation image is used to confirm thatthe guide catheter has been pulled out from the papilla. Thereafter, thecatheter is further pulled out toward the front side. Further, with theend of the guide catheter being accommodated in the channel openingportion 26, an elevator operation knob 48 of the therapeutic instrumentelevator base 27 is operated. With the operation of the elevatoroperation knob 48, the set-up wire 30 is operated and towed, and thetherapeutic instrument elevator base 27 is caused to swivel around theelevator base swivel supporting point 28 and raised as indicated by thedotted lines shown in FIG. 5.

Furthermore, when raising the therapeutic instrument elevator base 27 asshown in FIG. 6A, the guide wire 68 is led into the wire engagementgroove 321 along the substantially-V-shaped groove in the guide plane 29of the therapeutic instrument elevator base 27 as shown in FIG. 6B.Then, the guide wire 68 is releasably engaged while being inserted inthe wire engagement groove 321. At this moment, the guide wire 68 ispressed against an upper surface 273 side of the lead-in guide path 24of the end hard portion 21 by the therapeutic instrument elevator base27 as indicated by an arrow P in FIG. 6A. At this moment, since thereaction force indicated by an arrow Fr in FIG. 6A acts from the hardguide wire 68 so as to maintain the linear shape, this reaction forcecauses the guide wire 68 to be strongly engaged by being pushed into thewire engagement groove 321. As a result, the guide wire 68 ismechanically fixed to the end portion 17 of the insertion portion 12 inthis state.

Moreover, after an observation image of the endoscope 1 is used toconfirm that the guide wire 68 has been fixed, the guide catheter iscompletely pulled out from the operation portion 13 side of theendoscope 1 to the outside of the therapeutic instrument insertionchannel 23.

Thereafter, a therapeutic instrument which is subsequently used isinserted from the base end side of the guide wire 68. At this moment,with the guide wire 68 being used as a guide, the therapeutic instrumentis inserted into the therapeutic instrument insertion channel 23. Then,when the end of the therapeutic instrument is brought into contact withthe therapeutic instrument elevator base 27, the therapeutic instrumentelevator base 27 is lowered by the operation of the elevator operationknob 48. As a result, when the therapeutic instrument passes thevicinity of the therapeutic instrument elevator base 27, the thrustingforce of the therapeutic instrument at this moment pushes out the guidewire 68 from the wire engagement groove 321, thereby releasing fixationof the guide wire 68. In addition, the therapeutic instrument isinserted into a pancreatic/hepatic duct.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the guide wire 68 can be readily fixed by theregularly performed operation for raising the therapeutic instrumentelevator base 27, namely, operating the elevator operation knob 48 ofthe operation portion 13 on the front side in the endoscope 1.

Additionally, in this embodiment, since conventional therapeuticinstruments can be used as they are, the excellent operability can bemaintained without being deteriorated by using the therapeuticinstrument that an operator is used to dealing with. Therefore, thetherapeutic instrument can be easily replaced in a shorter time withoutimpairing the conventional operation method of the therapeuticinstrument or the operation style.

Further, since the guide wire 68 can be fixed at the end portion 17 ofthe insertion portion 12 of the endoscope 1, the length of the guidewire 68 can be shortened. Therefore, rolling of the guide wire 68 can befacilitated, and a large operation space is no longer necessary.Furthermore, replacement of the therapeutic instrument can befacilitated, and the number of assistants can be decreased, whichresults in reduction in the operation time.

Moreover, by forming the wire engagement groove 321 into a substantiallyV shape, the guide wire 68 whose outside diameter subtly differs can bestably and strongly engaged with the wire engagement groove 321. Inaddition, by providing the wire engagement groove 321 to the therapeuticinstrument elevator base 27, the guide wire 68 led to the guide plane 29is constantly placed in the same wire engagement groove 321. Therefore,at the time of the operation for fixing the guide wire 68, the fixedstate of the guide wire 68 is constantly stabled each and every time,and irregularities in the fixing strength caused due to a position ofthe guide wire 68 can be eliminated.

Additionally, in this embodiment, the relationship between the slitwidth (groove width) T1 of the wire engagement groove 321, the wirediameter D1 of the guide wire 68 and the outside diameter D2 of thetherapeutic instrument or any other counterpart such as the catheter 67is set to “D1≦T1<D2”. Therefore, as indicated by a dotted line in FIG.6B, the therapeutic instrument which is usually used, for example, thetube-like catheter 67 fitted on the guide wire 68 can be successfullyused without being caught in the wire engagement groove 321.

Further, FIGS. 7A to 7C show a second embodiment according to thepresent invention. In this embodiment, the structure of the end portion17 of the insertion portion 12 in the endoscope 1 according to the firstembodiment is modified as follows.

That is, in this embodiment, a slit-like wire engagement groove 331corresponding to the wire engagement groove 321 of the therapeuticinstrument elevator base 27 for fixing the guide wire 68 in the firstembodiment is provided on the upper surface 273 side of the lead-inguide path 24 of the end hard portion 21. The relationship between theopening portion slit width (groove width) T1 of the wire engagementgroove 331, the wire diameter D1 of the guide wire 68 and the outsidediameter D2 of the therapeutic instrument or any other therapeuticinstrument such as the guide catheter is set to “D1≦T1<D2” as in thefirst embodiment.

The effect of this embodiment will now be described. When the endoscope1 according to this embodiment is used, as in the first embodiment,after the guide catheter and the guide wire 68 are inserted into thebody through the channel 23, the elevator operation knob 48 of thetherapeutic instrument elevator base 27 is operated with the guidecatheter being pulled into the introduction guide path 24 or the channel23. With the operation of the elevator operation knob 48, the set-upwire 30 is operated to be towed, and the therapeutic instrument elevatorbase 27 is caused to swivel around the elevator base swivel supportingpoint 28 and raised as indicated by dotted lines in FIG. 7C.

Furthermore, when raising the therapeutic instrument elevator base 27,the guide wire 68 is pressed against the upper surface 273 side of thelead-in guide path 24 of the end hard portion 21 by the therapeuticinstrument elevator base 27 as shown in FIG. 7C.

At this moment, since the reaction force acts from the hard guide wire68 so as to maintain the linearity, the guide wire 68 is stronglyengaged in the wire engagement groove 331 of the end hard portion 21 bythis reaction force. Therefore, as shown in FIG. 7A, the guide wire 68is mechanically fixed to the end portion 17 of the insertion portion 12in this state.

Moreover, after confirming that the guide wire 68 has been fixed, theguide catheter is completely pulled out from the operation portion 13side of the endoscope 1 to the outside of the therapeutic instrumentinsertion channel 23.

Then, a therapeutic instrument which is subsequently used is insertedfrom the base end side of the guide wire 68. At this moment, with theguide wire 68 being used as a guide, the therapeutic instrument isinserted into the treatment insertion channel 23. Then, when the end ofthe therapeutic instrument is brought into contact with the therapeuticinstrument elevator base 27, the therapeutic instrument elevator base 27is lowered by the operation of the elevator operation knob 48. When thetherapeutic instrument passes the vicinity of the therapeutic instrumentelevator base 27 in this state, the guide wire 68 is pushed out from thewire engagement groove 331 by the thrusting force of the therapeuticinstrument at this moment, thereby releasing fixation of the guide wire68.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the guide wire 68 can be readily fixed by only theoperation for raising the therapeutic instrument elevator base 27 whichis usually carried out on the front operation portion 13 side in theendoscope 1. Thus, the advantage similar to that in the first embodimentcan be also obtained in this embodiment.

Moreover, in this embodiment, since the relationship between the openingportion slit width (groove width) T1 of the wire engagement groove 331,the wire diameter D1 of the guide wire 68, and the outside diameter D2of the therapeutic instrument or any other therapeutic instrument suchas the guide catheter is set to “D1≦T1<D2”, the regularly usedtherapeutic instrument can be successfully used without being caught inthe wire engagement groove 331.

As a modification of the first and second embodiments, it is possible toprovide both the wire engagement grove 331 provided on the upper surface273 side of the lead-in guide path 24 of the end hard portion 21described in connection with the second embodiment and the wireengagement groove 321 provided on the guide plane 29 of the therapeuticinstrument elevator base 27 described in connection with the firstembodiment, as shown in FIG. 7D.

The effect obtained by this modification is that, as in the first andsecond embodiments, the guide wire 68 enters the respective wireengagement grooves 321 and 331 and is engaged at the two points byraising the therapeutic instrument elevator base 27.

The advantage obtained by this modification lies in that engagement atthe two points increases the fixation strength in addition to theadvantage similar to that in the above-described first and secondembodiments.

Moreover, FIGS. 8A and 8B show a third embodiment. In this embodiment,the structure of the end portion 17 of the insertion portion 12 in theendoscope 1 according to the first embodiment is modified as follows.

That is, in this embodiment, as shown in FIGS. 8A and 8B, a slit-likewire engagement groove 321 for releasably engaging the guide wire 68 isprovided on the bottom of the substantially-V-shaped groove in the guideplane 29 of the therapeutic instrument elevator base 27. Here, as shownin FIG. 8A, the central axis of the wire engagement groove 321 isdetermined as M1, and the central axis of the guide plane 29 isdetermined as M2. In this state, by inclining the part between M1 and M2by θ, an angle of the wire engagement groove 321 can be inclined by θ.

It is to be noted that with respect to M1 this inclination θ may begiven to either the object lens side or the opposite side to the objectlens with M1 therebetween.

Further, the wire engagement groove 321 does not have to be provided atan intersection between the central axis M1 of the wire engagementgroove 321 and the central axis M2 of the guide plane 29. For example,as shown in FIG. 8C, the wire engagement groove 321 may be provided at aposition deviating from the center of the guide plane 29 as shown inFIG. 8C.

In this embodiment, when raising the therapeutic instrument elevatorbase 27, the guide wire 68 is led into the wire engagement groove 321obliquely provided with respect to the insertion portion axial directionalong the guide plane 29 by the therapeutic instrument elevator base 27,and fitted in the wire engagement groove 321 as shown in FIG. 8B,thereby being releasably engaged. The effect obtained thereafter issimilar to that of the first embodiment mentioned above.

Furthermore, FIG. 9 shows a fourth embodiment according to the presentinvention. In this embodiment, the structure of the therapeuticinstrument elevator base 27 according to the first embodiment ismodified as follows.

That is, in this embodiment, there is formed a surface finished plane541 having the large friction resistance which has been subjected tosurface finishing by which minute irregularities are formed to roughenthe inner surface of the wire engagement groove 321 in the therapeuticinstrument elevator base 27 according to the first embodiment. Thissurface finished plane 541 is formed by, for example, surface finishingfor causing the chemical reaction such as corrosion on the inner surfaceof the wire engagement groove 321 or any other finishing for embeddingor attaching a member having the large friction resistance, e.g.,rubber, silicon or any other elastomer.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the advantage similar to that in the firstembodiment can be obtained, and the friction resistance between theguide wire 68 and the wire engagement groove 321 is increased by thesurface finished plane 541 of the inner surface of the wire engagementgroove 321 in the therapeutic instrument elevator base 27, therebyincreasing a quantity of fixing power for the guide wire 68.

Furthermore, FIGS. 10A and 10B show a fifth embodiment according to thepresent invention. In this embodiment, the structure of the therapeuticinstrument elevator base 27 of the endoscope 1 in the first embodimentis changed as follows.

That is, in the therapeutic instrument elevator base 27 of thisembodiment, there is provided a chamfered portion 551 obtained bychamfering the entire edge line between the wire engagement groove 321and the guide plane 521.

The following advantage can be obtained in this embodiment. That is, theadvantage similar to that in the first embodiment can be obtained inthis embodiment. In addition to this, when the therapeutic instrumentelevator base 27 is raised, the guide wire 68 is guided along thechamfered portion 551 and can thereby readily enter the wire engagementgroove 321. Moreover, when inserting the guide wire 68 or any othertherapeutic instrument, it is advantageously possible to eliminatedamages to the edge portion of the wire engagement groove 321 which aregiven when the guide wire 68 or any other therapeutic instrument arecaught at this edge portion according to the present invention.

In addition, FIGS. 11A and 11B show a sixth embodiment. In thisembodiment, the structure of the therapeutic instrument elevator base 27of the endoscope 1 in the first embodiment is changed as follows.

That is, in this embodiment, engagement protrusions 502 for narrowingthe width of the opening end portion of the wire engagement groove 321are provided at the upper portions of the wall surfaces 501 on the bothsides in the wire engagement groove 321 of the therapeutic instrumentelevator base 27 A distance between the engagement protrusions 502 onthe both sides at the opening end portion of the wire engagement groove321 is set so as to be a gap which is slightly narrower than the outsidediameter dimension of the guide wire 68.

The effect of this embodiment will now be described. In this embodiment,as in the therapeutic instrument elevator base 27 of the endoscope 1according to the first embodiment, with the guide catheter being pulledinto the therapeutic instrument insertion channel 23, the guide wire 68is led to the wire engagement groove 321 by the guide plane 29 of thetherapeutic instrument elevator base 27 by raising the therapeuticinstrument elevator base 27.

At this moment, as a swiveling angle of the therapeutic instrumentelevator base 27 increases with the swiveling operation of thetherapeutic instrument elevator base 27, the guide wire 68 is stronglypushed by the protrusions 502 from the outside, and the guide wire 68starts to be elastically deformed. Then, with an appropriate anglebefore the swiveling angle of the therapeutic instrument elevator base27 reaches a maximum set-up angle, the guide wire 68 gets over theprotrusions 502, and the guide wire 68 is fitted in the wire engagementgroove 321 as shown in FIG. 11B. As a result, the guide wire 68 is fixedwhile being in contact with four points, i.e., the wall surfaces 501 onthe both sides and the engagement protrusions 502 on the both sides inthe wire engagement groove 321 of the therapeutic instrument elevatorbase 27.

Thereafter, the guide catheter is pulled out at a blast, and any othertherapeutic instrument is inserted with the guide wire 68 as a guide. Atthis moment, when the inserted therapeutic instrument passes along thewire engagement groove 321, the guide wire 68 is pushed out from thewire engagement groove 321 by the thrusting force of the therapeuticinstrument, and fixation of the guide wire 68 is released.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, as in the endoscope 1 of the first embodiment, theguide wire 68 can be easily fixed by only the usually performedoperation for raising the therapeutic instrument elevator base 27 bywhich the elevator operation knob 48 of the front operation portion 13in the endoscope 1 is operated.

Also, in this embodiment, in addition to the advantage similar to thatof the endoscope 1 according to the first embodiment, in the case offixing the guide wire 68, when the guide wire 68 gets over theengagement protrusions 502 on the both sides of the opening end portionin the wire engagement groove 321 from the outside, the guide wire 68can be further strongly fixed by sandwiching the guide wire 68 by thewire engagement groove 321 and the engagement protrusions 502 on theboth sides.

Additionally, when fixing the guide wire 68, the force of the guide wire68 to move in the upper surface direction of the therapeutic instrumentelevator base 27 can be suppressed by the engagement protrusions 502 onthe both sides.

Further, as in the first modification of the therapeutic instrumentelevator base 27 in the sixth embodiment shown in FIG. 12A, theengagement protrusions 502 on the both sides of the opening end portionin the wire engagement groove 321 of the therapeutic instrument elevatorbase 27 may be provided in the entire area of the wire engagement groove321 or a part of the wire engagement groove 321 along the insertionportion axial direction. Furthermore, as in the second modification ofthe therapeutic instrument elevator base 27 in the sixth embodimentshown in FIG. 12B, a plurality of engagement protrusions 502 may beprovided on the both sides of the opening end portion in the wireengagement groove 321 of the therapeutic instrument elevator base 27.

Furthermore, as in the third modification of the therapeutic instrumentelevator base 27 in the sixth embodiment shown in FIG. 12C, theengagement protrusion 502 may be provided on only one side of theopening end portion in the wire engagement groove 321 of the therapeuticinstrument elevator base 27 so as not to extremely lower the fixingcapability for the guide wire 68. When the engagement protrusion 502 isprovided on only one surface of the opening end portion in the wireengagement groove 321 of the therapeutic instrument elevator base 27 inthis manner, since the quantity of the operation force at the time ofinserting/removing the guide wire 68 into/from the wire engagementgroove 321 is reduced, the fixing operation of the guide wire 68 canbecome advantageously relatively easy.

Moreover, FIGS. 13 to 15B show a seventh embodiment according to thepresent invention. In this embodiment, the structure of the therapeuticinstrument elevator base 27 of the endoscope 1 according to the firstembodiment is modified as follows.

That is, in this embodiment, the wire engagement groove 321 of thetherapeutic instrument elevator base 27 is provided at a position atwhich any other therapeutic instrument doesn't come into contact withthe wire engagement groove 321 when the therapeutic instrument movesin/out with the therapeutic instrument elevator base 27 being lowered asshown in FIG. 13. FIG. 13 is a cross-sectional view when the therapeuticinstrument elevator base 27 is lowered with the guide catheter 267 beinginserted, and FIG. 14 is a cross-sectional view when the therapeuticinstrument elevator base 27 is raised. Further, the wire engagementgroove 321 of the therapeutic instrument elevator base 27 is constitutedby the guide plane 521, an end plane 522 and a connection plane 523connecting these planes.

Moreover, FIG. 15A is a front view of the therapeutic instrumentelevator base 27, and FIG. 15B is a rear view of the therapeuticinstrument elevator base 27. In this embodiment, as shown in FIGS. 15Aand 15B, the wire engagement groove 321 of the therapeutic instrumentelevator base 27 is arranged at a position which cannot seen from thefront side. In addition, the wire engagement groove 321 of thetherapeutic instrument elevator base 27 is formed so as to be graduallydeep from the connection plane 523 toward the end plane 522. As aresult, it is set in such a manner that the wire engagement groove 321is exposed to a traveling position of the guide wire 68 as thetherapeutic instrument elevator base 27 is raised.

The effect of this embodiment will now be described. In this embodiment,as in the first embodiment, with the guide catheter 267 being pulledinto the therapeutic instrument insertion channel 23, the wireengagement groove 321 appears by raising the therapeutic instrumentelevator base 27, and the guide wire 68 is pinched and fixed. Any otherprocess is similar to that in the first embodiment.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, as in the first embodiment, the guide wire 68 can beeasily fixed by only the usually performed operation for raising thetherapeutic instrument elevator base 27 by which the elevator operationknob 48 of the front operation portion 13 of the endoscope 1 isoperated.

Moreover, in this embodiment, in addition to the advantage similar tothat of the endoscope 1 according to the first embodiment, since thewire engagement groove 321 doesn't appear on the guide plane 521 whenthe therapeutic instrument elevator base 27 is lowered, the therapeuticinstrument cannot be damaged, and the therapeutic instrument cansmoothly move in/out.

In addition, FIGS. 16 to 18 show an eighth embodiment according to thepresent invention. In this embodiment, the structure of the therapeuticinstrument elevator base 27 of the endoscope 1 in the first embodimentis changed as follows.

That is, although it is desirable to design the wire engagement groove321 of the therapeutic instrument elevator base 27 to catch the guidewire 68 on the entire surface of the wire engagement groove 321 as shownin FIG. 17 when the guide wire 68 is raised, a certain quantity ofdisplacement is actually generally generated on the contact surfacebetween the wire engagement groove 321 and the guide wire 68 in therelationship of the machining accuracy as shown in FIG. 18. For example,when the guide wire 68 is raised by the therapeutic instrument elevatorbase 27, it is ideal that the entire bottom portion of the wireengagement groove 321 is in contact with the guide wire 68 as shown inFIG. 17. An angle between an insertion portion axis (central line) O andthe bottom portion (contact surface with the guide wire 68) of the wireengagement groove 321 at this moment is determined as θ.

In addition, in the relationship of the machining accuracy of thetherapeutic instrument elevator base 27, the displacement may begenerated in the contact surface between the wire engagement groove 321and the guide wire 68. Assuming that an angle between the insertionportion axis O and the bottom portion of the wire engagement groove 321is θ2 when this displacement is produced, the relationship of “θ<θ2” maybe attained. In this case, since the end portion of the guide wire 68 isheld down by the end portion of the wire engagement groove 321, adistance L2 between two points, i.e., the guide wire contact point ofthe therapeutic instrument elevator base 27 holding down the guide wire68 and the guide wire contact point of the lead-in guide path 24 in theend hard portion 21 is relatively long. Therefore, in this state, thereis a problem that the fixing strength for the guide wire 68 is lowered.

In this embodiment, taking a tolerance obtained by finishing the wireengagement groove 321 of the therapeutic instrument elevator base 27into consideration, when the guide wire 68 is raised by the therapeuticinstrument elevator base 27 as shown in FIG. 16, the angle θ1 betweenthe insertion portion axis O and the wire engagement groove 321 of thetherapeutic instrument elevator base 27 is set with respect to the angleθ between the insertion portion axis O and the wire engagement groove321 in the ideal stage shown in FIG. 17 so that “θ>θ1” can be achieved.As a result, when the guide wire 68 is raised by the therapeuticinstrument elevator base 27, the front side of the wire engagementgroove 321 of the therapeutic instrument elevator base 27 can be sethigher than an ideal position of the end portion of the wire engagementgroove 321 on the front side shown in FIG. 17, and the contact pointwith the guide wire 68 is arranged on the front side of the wireengagement groove 321. Additionally, in this case, since the distance L1between two points, i.e., the guide wire contact point of thetherapeutic instrument elevator base 27 holding down the guide wire 68and the guide wire contact point of the lead-in guide path 24 in the endhard portion 21 becomes smaller than L2 shown in FIG. 18 (L1<L2 ), thefixing strength for the guide wire 68 can be increased as compared withthe case illustrated in FIG. 18.

Therefore, since a distance between two points, i.e., the wireengagement groove 321 of the therapeutic instrument elevator base 27 andthe guide wire contact point of the lead-in guide path 24 in the endhard portion 21 does not become long due to irregularities in theworking process when the guide wire 68 is raised by the therapeuticinstrument elevator base 27 in this embodiment, the fixing strength forthe guide wire 68 is not lowered by irregularities in machining the wireengagement groove 321 of the therapeutic instrument elevator base 27,and there is the advantage that the fixing strength of the guide wire 68can be stably maintained.

Further, FIGS. 19 and 20 show a ninth embodiment according to thepresent invention. In this embodiment, the structure of the therapeuticinstrument elevator base 27 according to the first embodiment is changedas follows.

That is, in this embodiment, as shown in FIG. 19, the wire engagementgroove 321 for strongly bending the set-up position of the guide wire 68which is raised by the therapeutic instrument elevator base 27 towardthe front side away from the position of the elevator base swivelsupporting point 28 when the therapeutic instrument elevator base 27 israised at the maximum set-up level is provided at the end portion of thetherapeutic instrument elevator base 27. This wire engagement groove 321is arranged at a part in the vicinity of the end of the guide wire 68 ofthe therapeutic instrument elevator base 27 in the guide plane 29.Further, when the therapeutic instrument elevator base 27 is raised atthe maximum set-up level, the wire engagement groove 321 is arranged ata position where it protrudes by an appropriate distance L1 toward thefront side away from the position of the elevator base swivel supportingpoint 28.

It is to be noted that the clearance between the wire engagement groove321 provided to the therapeutic instrument elevator base 27 and theupper surface 273 of the lead-in guide path 24 when the therapeuticinstrument elevator base 27 is raised is assured as in the prior art andmaintained so as not to interfere insertion and removal of the guidecatheter or any other therapeutic instrument.

Furthermore, a notch portion 463 obtained by scraping off a part opposedto the set-up angle stopper 462 at the end of the end hard portion 2 soas not to come into contact with the set-up angle stopper 462 is formedon a side wall surface 27 a on the guide plane side of the therapeuticinstrument elevator base 27 in such a manner that the insertion/removalproperty of the therapeutic instrument is not interfered when thetherapeutic instrument elevator base 27 is raised-at the maximum level.

Incidentally, the present invention is not restricted to theabove-described structure as long as it is the structure capable ofmaintaining the positional relationship between the wire engagementgroove 321 and the elevator base swivel supporting point 28.

On the contrary, FIG. 20 is a cross-sectional view of the end portion ofthe endoscope with the conventional guide wire 68 being fixed. As shownin FIG. 20, the position at which the guide wire 68 is fixed in the wireengagement groove 321 when the therapeutic instrument elevator base 27is raised to the maximum set-up position is arranged on the end sideaway from the elevator base-swivel supporting point 28 by approximatelyan appropriate distance L2.

The effect of this embodiment will now be described. In this embodiment,as in the first embodiment, with the guide catheter being pulled intothe therapeutic instrument insertion channel 23, the therapeuticinstrument elevator base 27 is raised. At this moment, since thetherapeutic instrument elevator base 27 is raised beyond theconventional maximum set-up angle position, the guide wire 68 can befurther bent. Therefore, the shear force between the wire engagementgroove 321 and the upper surface 273 of the lead-in guide path 24 andthe reaction force of the guide wire 68 further strongly act, and theguide wire 68 can be hence securely fixed in this state.

After confirming that the guide wire 68 is firmly fixed, the guidecatheter is pulled out and another therapeutic instrument is insertedover the guide wire 68. Consequently, at this moment, the therapeuticinstrument to be inserted sets down the therapeutic instrument elevatorbase 27 when passing along the wire engagement groove 321, and the guidewire 68 is pushed out from the wire engagement groove 321 by thethrusting force of this therapeutic instrument, and fixation between theguide wire 68 and the wire engagement groove 321 is released.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the advantage similar to the first embodiment can beobtained. In addition to this, there is an advantage that the guide wire68 can be further firmly fixed.

Incidentally, the above-described guide wire fixing means is notrestricted to one having the wire engagement groove 321, and only thetherapeutic instrument elevator base 27 may also function as this guidewire fixing means in order to bring in the set-up angle.

Further, FIG. 21 and FIGS. 22A to 22D show a 10th embodiment accordingto the present invention. In this embodiment, the elevator baseactuation mechanism 401 configured as shown in FIGS. 21 and 22A isprovided in place of the elevator base actuation mechanism 41 providedinside the operation portion 13 of the endoscope 1 according to thefirst embodiment.

A elevator base operation knob 402 is provided at the end edge portionof the operation portion 13 of the endoscope 1. To this elevator baseoperation knob 402 are provided an operation lever 403 and a fingerapplication portion 405 which is fixed to the outer end portion of theoperation lever 403 by the set screw as shown in FIG. 22A.

Furthermore, a fixing cylindrical body 406 for attaching the elevatorbase operation knob 402 is provided to the operation portion 13 of theendoscope 1 so as to protrude therefrom. A base end portion of thefixing cylindrical body 406 is fixed to a non-illustrated fixing frameprovided in an operation portion casing 13 a of the operation portion13.

Moreover, a rotating ring 407 is rotatably fitted in the fixingcylindrical body 406.

It is to be noted that a bearing portion 13 b for rotatably supportingthe rotating ring 407 is provided to the operation portion casing 13 a.

In addition, as shown in FIG. 21, a ring-like connection ring 403 a isprovided to the inner end portion of the operation lever 403. Thisconnection ring 403 a is screwed and fixed to the outer surface of therotating ring 407 by a plurality of set screws 408. Additionally, theelevator base operation knob 402 has the operation lever 403 beingrotatably supported along the central axis of the fixing cylindricalbody 406.

Further, a base end portion of a second link member 409 is fixed to theinner surface of the rotating ring 407. A substantially-L-shaped linkarm 409 a is provided to the second link member 409 so as to protrudetherefrom. The other end portion of the arm 49 in the elevator baseactuation mechanism 41 according to the first embodiment is connected tothe end portion of the link arm 409 a through a second link shaft 410 asa bar-like shaft member so as to be capable of swiveling. An engagementmember 411 consisting of a C type or E type snap ring is engaged withthe end portion on the opposite side to the end portion on the arm 49side in the second link shaft 410.

Furthermore, by rotating the operation lever 403 with the fingerapplication portion 405 as a supporting point in the swiveling operationof the elevator base operation knob 402 in the operation portion 13, thesecond link member 409 is operated to swivel through the rotating ring407, and the link member 44 is driven to move forward/backward along theaxial direction of the set-up wire 30 through the arm 49 with theswiveling operation of the second link member 409. As a result, theset-up wire 30 is towed, and the therapeutic instrument elevator base 27is caused to perform the derricking motion with the elevator base swivelsupporting point 28 at the center. Consequently, the therapeuticinstrument such as the guide catheter which is inserted into thetherapeutic instrument insertion channel 23 and led to the outside fromthe channel opening portion 26 is raised by raising the therapeuticinstrument elevator base 27.

Moreover, a braking mechanism 412 for restraining the swivel operationforce of the operation lever 403 of the elevator base operation knob 402is incorporated in the elevator base actuation mechanism 401 accordingto this embodiment. As shown in FIG. 22B, to the braking mechanism 412are provided a deterrent body 413 such as a pin which protrudes in themiddle of the operation lever 403 of the elevator base operation knob402 and a deterrence reinforcement member 414 which is arranged at aposition engaged with the deterrent body 413 and shown in FIG. 22C.

In addition, to the deterrence reinforcement member 414 is formed aguide groove 414 a to which the deterrent body 413 of the operationlever 403 is inserted and which has a substantially-U-shaped crosssection as shown in FIGS. 22C and 22D. This guide groove 414 a isextended along the swivel trajectory of the deterrent body 413 in theswiveling operation of the operation lever 403. Additionally, thedeterrent body 413 is configured to pass inside the guide groove 414 aof the deterrence reinforcement member 414.

Further, a friction resistance member 415 having a large frictionresistance is embedded in the guide groove 414 a of the deterrencereinforcement member 414 on one end side of the guide groove 414 a. Thisfriction resistance member 415 is arranged in an area through which thedeterrent body 413 passes in a range L in which swivel of the operationlever 403 should be restrained in the swiveling operation of theoperation lever 403 when rotating in that range.

The effect of this embodiment will now be described. In this embodiment,as in the endoscope 1 according to a 29th embodiment, the operationlever 403 of the elevator base operation knob 402 of the operationportion 13 is rotated in the operation for raising the therapeuticinstrument elevator base 27. At this moment, when the operation lever403 is rotated to the deterrence range L, the deterrent body 413 comesinto contact with the friction resistance member 415 in the guide groove414 a of the deterrence reinforcement member 414. As a result, the loadis applied to the swiveling operation of the operation lever 403, andbrake is put on the swiveling operation of the operation lever 403 andthis lever is fixed. Therefore, with the therapeutic instrument elevatorbase 27 being swiveled to the set-up position indicated by dotted linesin FIG. 57A, the therapeutic instrument elevator base 27 can be fixed.Thus, the guide wire 68 led to the outside from the channel openingportion 26 is sandwiched between the end surface of the lead-in guidepath 24 of the end hard portion 21 and the therapeutic instrumentelevator base 27 and mechanically fixed.

As described above, after confirming that the guide wire 68 has beenfixed, the guide catheter is completely pulled out to the outside of thetherapeutic instrument insertion channel 23 from the operation portion13 side of the endoscope 1.

Thereafter, a therapeutic instrument which is subsequently used isinserted from the base end side of the guide wire 68. At this moment,with the guide wire 68 being used as a guide, the therapeutic instrumentis inserted into the therapeutic instrument insertion channel 23. Then,when the therapeutic instrument hustles against the therapeuticinstrument elevator base 27, the operation lever 403 of the elevatorbase operation knob 402 is returned to its original position. At thismoment, the operation lever 403 exceeds the deterrence range L, and thedeterrent body 413 comes off the friction resistance member 415 in theguide groove 414 a of the deterrence reinforcement member 414, therebyreleasing fixation of the operation lever 403. Consequently, fixation ofthe guide wire 68 by the therapeutic instrument elevator base 27 isreleased.

In this embodiment, the following advantage can be demonstrated. Thatis, in this embodiment, since the braking mechanism 412 for restrainingthe swivel operation force of the operation lever 403 of the elevatorbase operation knob 402 is incorporated in the elevator base actuationmechanism 401, the fixed state of the guide wire 68 can be maintained byfixing the therapeutic instrument elevator base 27 with the therapeuticinstrument elevator base 27 being swiveled to the set-up positionindicated by dotted lines in FIG. 5. Therefore, while the guide wire isfixed, there is no need to grip the operation lever 403, therebyadvantageously improving the working property of an operator.

It is to be noted that the braking mechanism 412 according to thisembodiment may be incorporated into the operation lever 72 of alater-described guide wire fixing elevator base 267. In this case, withthe guide wire fixing elevator base 267 being swiveled to the set-upposition shown in FIG. 57C, the fixed state of the guide wire 68 can bemaintained by fixing the guide wire fixing elevator base 267. Therefore,while the guide wire 68 is fixed, there is no need to grip the operationlever 72 of the guide wire fixing elevator base 267, therebyadvantageously improving the working property of an operator.

Further, FIG. 23 shows a first modification of the 10th embodiment. Inthis modification, an elastic member 416 consisting of, e.g., two flatsprings 416 a and 416 b is arranged in the guide groove 414 a of thedeterrence reinforcement member 414 of the braking mechanism 412 inplace of the friction resistance member 415. This elastic member 416 isformed into such a shape as that the deterrent body 413 is insertedbetween the two flat springs 416 a and 416 b and the load is increasedas the deterrent body 413 is inserted. Furthermore, the advantagesimilar to that of the braking mechanism 412 according to an 11thembodiment can be also obtained in the elastic member 416 of thismodification.

Moreover, FIG. 51 shows a second modification of the 10th embodiment. Inthis modification, a notch 417 is provided to a tow knob 264 whichrotates around the axis along the circumferential direction of theoperation portion 13 as in a 33rd embodiment in place of the brakingmechanism 412 according to the 10th embodiment. In addition, there isprovided a braking mechanism which fixes rotation of the tow knob 264 byreleasably engaging a protrusion 418 which protrudes through anon-illustrated elastic member with this notch 417. Additionally, theadvantage similar to that of the braking mechanism 412 according to the11th embodiment can be also obtained in this modification.

Further, FIGS. 24 to 27 show the 11th embodiment according to thepresent invention. In this embodiment, there is provided elevatoroperating means 471 having a set-up range selection type structurecapable of appropriately and selectively changing the set-up range ofthe therapeutic instrument elevator base 27 according to the 9thembodiment in a plurality of stages.

That is, to the elevator operating means 471 according to thisembodiment is provided an elevator base actuation mechanism 472 havingthe structure shown in FIGS. 24 and 25A inside the operation portion 13having the substantially the same structure as the endoscope 1 accordingto the 10th embodiment.

A segment stopper member 473 with the central axis of the fixingcylindrical body 406 at the center is provided to this elevator baseactuation mechanism 472. As shown in FIG. 26, a two-stage protrusionportion 475 which protrudes in the stepped form in the upward directionorthogonal to a flat base plane 474 is formed on one end portion side ofthe stopper member 473. To this two-stage protrusion portion 475 areprovided a low-stage first stopper 475 a and a high-stage second stopper475 b. The high-stage second stopper 475 b is arranged on the endportion side of the stopper member 473 at the rear of the low-stagefirst stopper 475 a. Additionally, the stopper member 473 is fixed tothe casing 13 a of the operation portion 13 by a set screw 476.

Further, a height of the first stopper 475 a is set in such a mannerthat elastic deformation of the operation lever 403 is enabled so thatthe operation lever 403 of the elevator base operation knob 402 can getover the first stopper 475 a. Furthermore, the second stopper 475 b isset to a height that the operation lever 403 can not get over the secondstopper 475 b by elastic deformation of the operation lever 403.Moreover, in the swivel operation of the elevator base operation knob402, the range of the elevator operation of the first stage isrestricted at a position B in FIG. 24 where the operation lever 403 ofthe elevator base operation knob 402 hustles against the fist stopper475 a. At this moment, by swiveling the operation lever 403 in theelevator operation range of the first stage from a position A to theposition B in FIG. 24, it is possible to perform the usual elevatoroperation for the therapeutic instrument for guiding the therapeuticinstrument and the like to a desired position as in the prior art.

In addition, by lifting the finger application portion 40S of theelevator base operation knob 402 in a direction indicated by an arrow inFIG. 25B at the position B and provoking elastic deformation of theoperation lever 403, the operation lever 403 can get over the fiststopper 475 a as shown in FIG. 25B. Further, after the operation lever403 is caused to get over the first stopper 475 a, the elevatoroperation range of the second stage can be restricted by swiveling theoperation lever 403 to a position C shown in FIG. 24 at which theoperation lever 403 hustles against the second stopper 475 b. Therefore,in this embodiment, the set-up range of the therapeutic instrumentelevator base 27 can be changed in two stages by the low-stage firststopper 475 a and the high-stage second stopper 475 b in the stoppermember 473 of the elevator operating means 471. Furthermore, at thisposition C, the guide wire 68 led from the channel opening portion 26 tothe outside is sandwiched and mechanically fixed between the end surfaceof the lead-in guide path 24 of the end hard portion 21 and thetherapeutic instrument elevator base 27.

The effect of this embodiment will now be described. In this embodiment,in the swiveling operation of the elevator base operation knob 402, theelevator operation range of the first stage is restricted at theposition B shown in FIG. 24 at which the operation lever 403 of theelevator base operation knob 402 hustles against the low-stage firststopper 475 a in the stopper member 473 of the elevator operating means471. At this moment, by swiveling the operation lever 403 in theelevator operation range of the first stage from the position A to theposition B in FIG. 24, it is possible to perform the usual elevatoroperation for the therapeutic instrument for guiding the therapeuticinstrument and the like to a desired position as in the prior art.

Moreover, when fixing the guide wire 68, with the guide catheter beingpulled into the therapeutic instrument insertion channel 23 as in thefirst embodiment, the therapeutic instrument elevator base 27 is raisedby performing the swiveling operation of the operation lever 403.

At this moment, at the position B where the operation lever 403 hustlesagainst the first stopper 475 a, as indicated by an arrow in FIG. 25B,the operation lever 403 having come into contact with the first stopper475 a is elastically deformed so as to be deflected by pushing up thefinger application portion 405 toward the outside. As a result, asindicated by dotted lines in FIG. 27, the operation lever 403 can getover the first stopper 475 a.

In addition, after the operation lever 403 is caused to get over thefirst stopper 475 a, the therapeutic instrument elevator base 27 can befurther raised by swiveling the operation lever 403 to the position Cshown in FIG. 24 at which the operation lever 403 hustles against thesecond stopper 475 b, thereby restricting the elevator operation rangeof the second stage. Additionally, at the position C, the guide wire 68led to the outside from the channel opening portion 26 is sandwiched andmechanically securely fixed between the end surface of the lead-in guidepath 24 of the end hard portion 21 and the therapeutic instrumentelevator base 27.

Therefore, in this embodiment, the low-stage first stopper 475 a and thehigh-stage second stopper 475 b are provided to the stopper member 473of the elevator operating means 471, and the set-up range of thetherapeutic instrument elevator base 27 can be changed in two stages byonly changing the operation of the regularly used operation lever 403 soas to be switched between the state in which the regularly usedoperation lever 403 abuts on the first stopper 475 a and the state inwhich the same abuts on the high-stage second stopper 475 b. Thus, sincethere is no need to newly provide a complicated operating means forchanging the set-up range of the therapeutic instrument elevator base27, there can be obtained an advantage that an operator is not confusedand the endoscope can be stably operated.

In addition, fine adjustment of the swiveling position of the operationlever 403 does not have to be carried out in the case of raising thetherapeutic instrument and the case of fixing the guide wire 68, and theoperation lever can be used differently depending on the case of simplyraising the therapeutic instrument and the case of fixing the guide wire68, thereby reducing the burden of an operator during examination.

Additionally, after rotating the operation lever 403 of the elevatorbase operation knob 402 to the fixing position of the guide wire 68, theoperation lever 403 does not hustle against the stopper member 473 ofthe elevator operating means 471 in the operation for releasing fixationof the guide wire 68 during which the operation lever 403 is swiveled inthe direction of the position A from the position C through the positionB, thereby readily performing the operation for returning thetherapeutic instrument elevator base 27 to the set-down position.

Further, it is good enough that the clearance between the therapeuticinstrument elevator base 27 and the wire engagement groove 321 accordingto the 9th embodiment is assured as in the prior art so as not toprevent insertion/removal of the therapeutic instrument at the positionB. Furthermore, the clearance between the therapeutic instrumentelevator base 27 and the wire engagement groove 321 can be narrowed whenmoving from the position B to the position C, thus increasing the fixingstrength of the guide wire 68.

It is to be noted that the present invention may adopt the structure inwhich a number of components can be reduced by integrally molding thestopper member 473 with the operation portion casing 13 a of theoperation portion 13. Moreover, although the above has described thestructure in which the two stoppers, i.e., the low-stage first stopper475 a and the high-stage second stopper 475 b are provided in thestopper member 473 in this embodiment, three or more stoppers may beprovided according to need.

In addition, although the above has described the structure in which thestopper member 473 is provided to the casing 13 a of the operationportion 13 in this embodiment, the present invention is not restrictedthereto, and the stopper members may be provided at parts where theycome into contact with the operation lever 403, the fixing cylindricalbody 406, the second link member 409 and the link member 44,respectively, so as not to deteriorate the set-up operability of thetherapeutic instrument elevator base 27.

Additionally, the shape of the stopper member 473 is not restricted tothe plate-like member described above, and an elastic member 476 such asa flat spring can substitute as in the modification of the 11thembodiment shown in FIG. 28. In this elastic member 476, a first stopper475 a for restricting the elevator operation range of the first stage isformed by a pair of protrusion portions 477 a and 477 a which protrudeon the trajectory of the operation lever 403, and a second stopper 475 bfor restricting the elevator operation range of the second stage isformed by a pair of protrusion portions 477 b and 477 b which protrudeat positions away from the first stopper 475 a.

Further, FIGS. 29A, 29B and 30 show a 12th embodiment according to thepresent invention. In this embodiment, when the therapeutic instrumentelevator base 27 of the endoscope 1 according to the first embodiment israised, the therapeutic instrument elevator base 27 is arranged in sucha manner that the therapeutic instrument elevator base 27 is partiallybrought into an observation visual field 482 obtained by an object lens481 of the object optical system of the endoscope 1 in FIG. 30.

It is to be noted that FIG. 29B shows an observation image 483 obtainedby the object lens 481 of the endoscope 1. Furthermore, the objectoptical system of the endoscope 1 is arranged at a position at which apart of the guide wire 68 fixed by the wire engagement groove 321 of thetherapeutic instrument elevator base 27 shown in the observation image483 is focused.

The effect of this embodiment will now be described. In this embodiment,as in the endoscope 1 according to the first embodiment, with the guidecatheter being pulled into the therapeutic instrument insertion channel23, the therapeutic instrument elevator base 27 and the guide wire 68fixed to the therapeutic instrument elevator base 27 are brought intothe visual field 482 of the object lens 481 of the object optical systemby raising the therapeutic instrument elevator base 27. Furthermore,when the therapeutic instrument elevator base 27 is raised at themaximum level, the therapeutic instrument elevator base 27 is arrangedat the corner of the observation image 483 obtained by the object lens481 of the endoscope 1 so as to be capable of being confirmed as shownin FIG. 29B. At this moment, the object lens 481 focuses on the guidewire 68. In this state, the guide catheter is pulled out at a blast, andany other instrument is inserted with the guide wire being used as aguide. When the end of the therapeutic instrument hustles against thetherapeutic instrument elevator base 27, the therapeutic instrumentelevator base 27 is lowered, and the guide wire 68 is pushed out fromthe wire engagement groove 321 by the thrusting force from thetherapeutic instrument when the therapeutic instrument passes along thewire engagement groove 321, thereby releasing fixation of the guide wire68.

The following advantage can be obtained in this embodiment. That is, inthis embodiment, as in the endoscope 1 according to the firstembodiment, the guide wire 68 can be readily fixed by only the usuallyperformed elevator operation of the therapeutic instrument elevator base27 in which the elevator operation knob 48 of the front operationportion 13 of the endoscope 1 is operated.

Also, in addition to the advantage similar to that of the endoscope 1according to the first embodiment, by watching the observation imageobtained by the object lens 481 of the endoscope 1, it is possible tovisually confirm whether the guide wire 68 has been assuredly fixed.Thus, there is an advantage that an erroneous operation such asaccidentally pulling out the unfixed guide wire 68 can be prevented fromoccurring.

Furthermore, since the therapeutic instrument elevator base 27 isbrought into the observation visual field 482 obtained by the objectlens 481 of the object optical system of the endoscope 1, there is anadvantage that the state of the therapeutic instrument elevator base 27having moved to the fixed position of the guide wire 68 can be visuallyconfirmed.

Incidentally, this embodiment is not necessarily restricted to theendoscope 1 according to the first embodiment, and it can be applied toall which have a mechanism for fixing the guide wire 68 by using theguide wire fixing member.

Moreover, FIG. 31A show a 13th embodiment according to the presentinvention. In this embodiment, an index 491 consisting of a stripemarking is provided to the guide wire 68 which is fixed by the guidewire fixing means such as the therapeutic instrument elevator base 27 ofthe endoscope 1 according to the 12th embodiment and brought into theobservation visual field 482 obtained by the object lens 481 of theobject optical system of the endoscope 1.

Incidentally, display indicative of displacement of a position of theguide wire 68 such as a scale 492 of a first modification shown in FIG.31B or numerical FIGS. 493 of a second modification shown in FIG. 31Ccan suffice the index 491.

The following advantage can be obtained in this embodiment. That is, theadvantage similar to that of the 12th embodiment can be obtained in thisembodiment, and there is an advantage that the displacement of the guidewire 68 can be easily visually confirmed as well as the advantagesimilar to that of the 12th embodiment.

In addition, FIG. 32A shows a 14th embodiment according to the presentinvention. In this embodiment, the position of the wire engagementgroove 321 in the therapeutic instrument elevator base 27 according tothe first embodiment is set to be lower than the therapeutic instrumentguide plane 511 of the end cover 22 provided at the end portion 17 ofthe insertion portion 12 of the endoscope 1.

It is to be noted that FIG. 32B shows the set-down state of theconventional treatment elevator base 27 when the guide wire 68 is fixed.As shown in FIG. 32B, in the conventional therapeutic instrumentelevator base 27, the position of the wire engagement groove 321 of thetherapeutic instrument elevator base 27 is arranged at a position higherthan the therapeutic instrument guide plane 511 of the end cover 22 ofthe insertion portion 12.

The effect of this embodiment will now be described. In the therapeuticinstrument elevator base 27 according to this embodiment, as in thetherapeutic instrument elevator base 27 of the endoscope 1 according tothe first embodiment, after fixing the guide wire 68 and removing theguide catheter, another therapeutic instrument is inserted with theguide wire 68 functioning as a guide. At this moment, in the therapeuticinstrument elevator base 27 according to this embodiment, by completelysetting down the therapeutic instrument elevator base 27, the guide wire68 which has been pinched and fixed by the wire engagement groove 321 ispushed up by the therapeutic instrument guide plane 511 of the end cover22. Therefore, the guide wire 68 is pushed out from the wire engagementgroove 321 by this thrusting force and fixation of the guide wire 68 isreleased.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the guide wire 68 is pushed out from the wireengagement groove 321 by only the operation of the therapeuticinstrument elevator base 27, and fixation of the guide wire 68 can bereleased. Therefore, when the inserted therapeutic instrument passesalong the wire engagement grove 321, there is the advantage that theworking property can be further improved as compared with the method forreleasing fixation of the guide wire 68 by the thrusting force of thetherapeutic instrument.

Additionally, FIGS. 33A and 33B show a 15th embodiment according to thepresent invention. In this embodiment, in place of the wire engagementgroove 321 according to the first embodiment, a guide wire fixingmechanism 102 for fixing the guide wire 68 is constituted by embeddingan elastic member 101 made of a material having a large frictionresistance such as rubber in the front-side wall surface 26 a of thechannel opening portion 26, raising the therapeutic instrument elevatorbase 27 and welding the guide wire 68 to the elastic member 101 withpressure by the therapeutic instrument elevator base 27, as shown inFIGS. 33A and 33B.

The effect of this embodiment will now be described. In this embodiment,as in the first embodiment, after inserting the guide wire 68 and theguide catheter into the therapeutic instrument insertion channel 23, thetherapeutic instrument elevator base 27 is raised by a set-up wire 30 astowing means by operating the elevator operation knob 48 with the guidecatheter being pulled into the lead-in guide path 24 or the channel 23when the guide wire 68 is fixed. At this moment, as indicated by dottedlines in FIG. 33B, the therapeutic instrument elevator base 27 is raisedto a position at which the guide wire 68 is welded to the elastic member101 with pressure by the therapeutic instrument elevator base 27. Whenthe guide wire 68 is sandwiched between the therapeutic instrumentelevator base 27 and the elastic member 101, the guide wire 68 does notslip by the friction resistance of the elastic member 101 but fixed.

In this embodiment, the guide wire 68 can be fixed by raising thetherapeutic instrument elevator base 27 by the operation of the elevatoroperation knob 48 on the front operation portion 13 of the endoscope 1and sandwiching the guide wire 68 between the therapeutic instrumentelevator base 27 and the elastic member 101, thereby obtaining theadvantage similar to that of the first embodiment.

Further, in this embodiment in particular, only embedding the elasticmember 101 in the front-side wall surface 26 a of the channel openingportion 26 can suffice, and an additional component such as an impetusgiving mechanism does not have to be newly provided. Therefore, thestructure of the end portion 17 of the endoscope 1 is not complicated,which is similar to the prior art.

Incidentally, in the endoscope 1 which is of a type that the end cover22 constituted by the elastic member can be attached/detached, as in amodification shown in FIG. 34, the guide wire fixing portion 103 whichis extended to the front-side wall surface 26 a of the channel openingportion 26 may be provided integrally with the end cover 22 at a partcorresponding to the channel opening portion 26 in the end cover 22. Inthis case, in the endoscope 1 in which the end cover 22 can beattached/detached, the guide wire fixing mechanism 102 can be easilyprovided to a current scope by replacing the conventional end cover withthe end cover 22 according to this embodiment.

Furthermore, the elastic member 101 according to the 15th embodiment maybe substituted by a magnet. In this case, as in the first embodiment,after inserting the guide catheter and the metal guide wire 68 into thetherapeutic instrument insertion channel 23, the therapeutic instrumentelevator base 27 is raised by the elevator operation knob 48 in theoperation portion 13 when the guide catheter is drawn into the channelopening portion 26. As a result, the elevator guide wire 68 is attractedto the magnet on the front-side wall surface 26 a of the channel openingportion 26 by the magnetic force.

Thereafter, the guide catheter is completely pulled out, and atherapeutic instrument which is subsequently used is inserted from thebase end side of the guide wire 68. Then, the therapeutic instrumentwhich is subsequently used is inserted into the therapeutic instrumentinsertion channel 23 with the guide wire 68 functioning as a guide. Atthis moment, when the therapeutic instrument passes the position atwhich the guide wire 68 is fixed by the magnet, the attraction force isweakened, and the guide wire 68 moves away from the magnet. Moreover,the guide wire 68 is inserted into a pancreatic/hepatic duct (notshown). Therefore, the advantage which is the same as the 15thembodiment can be also obtained in this case.

In addition, in the endoscope 1 in which the end cover 22 can beattached/detached, the magnet may be embedded in a part corresponding tothe front-side wall surface 26 a of the channel opening portion 26 inthe end cover 22.

Additionally, FIGS. 35A and 35B show a 16th embodiment according to thepresent invention. In this embodiment, the guide wire engagement groove441 is provided on an inner wall surface 25 a of an accommodationchamber 25 of the therapeutic instrument elevator base 27 in the endcover 22 provided at the end portion 17 of the endoscope 1 according tothe first embodiment. The relationship between a groove width M1 of theguide wire engagement groove 441 and a wire diameter D1 of the guidewire 68 is set to, e.g., “M1≦D1”. The groove width M1 of the guide wireengagement groove 441 is set to a size that the guide wire 68 fits inthe guide wire engagement groove 441 when the guide wire 68 is pushed ina direction of the guide wire engagement groove 441 and the peripheralpart of the guide wire engagement groove 441 in the end cover 22 iselastically deformed.

Further, a guide plane 442 which guides the guide wire 68 in a directionof the guide wire engagement groove 441 is formed at the therapeuticinstrument elevator base 27. As shown in FIG. 35A, the guide plane 442is formed by an inclined plane notched on the side surface of theaccommodation chamber 25 opposed to the guide wire engagement groove 441in the state that the therapeutic instrument elevator base 27 is loweredand accommodated in the accommodation chamber 25 (standby position) asshown in FIG. 35A.

Furthermore, in the operation for raising the therapeutic instrumentelevator base 27, as the therapeutic instrument elevator base 27 swivelsfrom the standby position to the therapeutic instrument set-up positionwith the elevator base swivel supporting point 28 at the center, theguide wire 68 is guided to the direction of the guide wire engagementgroove 441 by the guide plane 442 of the therapeutic instrument elevatorbase 27, and the guide wire 68 is partially fitted in the guide wireengagement groove 441. In this state, the side surface of thetherapeutic instrument elevator base 27 pushes the guide wire 68 byfurther raising the therapeutic instrument elevator base 27 as shown inFIG. 35B, and the guide wire 68 is pushed and fixed between the guidewire engagement groove 441 and the side surface of the therapeuticinstrument elevator base 27.

The effect of this embodiment will now be described. In this embodiment,as in the first embodiment, the guide wire 68 is guided to the guidewire engagement groove 441 by the guide plane 442 of the therapeuticinstrument elevator base 27 when the therapeutic instrument elevatorbase 27 is raised with the guide catheter being accommodated in thetherapeutic instrument insertion channel 23, and the guide wire 68 ispartially fitted in the guide wire engagement groove 441.

In this state, the side surface of the therapeutic instrument elevatorbase 27 pushes the guide sire 68 by further raising the therapeuticinstrument elevator base 27, and the guide wire 68 is pushed and fixedbetween the guide wire engagement groove 441 and the side surface of thetherapeutic instrument elevator base 27. At this moment, the movement ofthe guide wire 68 trying to go out of the guide wire engagement groove441 can be restricted by maintaining the set-up state of the treatmentelevator base 27.

Thereafter, the guide catheter is pulled out from the therapeuticinstrument insertion channel 23 at a blast. Another therapeuticinstrument is subsequently inserted with the guide wire 68 as a guide.At this moment, when the end of the therapeutic instrument hustlesagainst the therapeutic instrument elevator base 27, the therapeuticinstrument elevator base 27 is lowered by the operation of the elevatoroperation knob 48. Further, when another therapeutic instrument passesalong the guide wire engagement groove 441, the guide wire 68 is pushedout from the guide wire engagement groove 441 by the thrusting forcefrom this therapeutic instrument, thereby releasing fixation of theguide wire 68.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the advantage similar to that of the endoscope 1according to the first embodiment can be obtained. In addition to this,further secure fixation is enabled by sandwiching the guide wire 68inserted into the guide wire engagement groove 441 between thetherapeutic instrument elevator base 27 and the guide wire engagementgroove 441 and fixing it.

Furthermore, FIGS. 36A and 36B show a 17th embodiment according to thepresent invention. In this embodiment, the guide wire engagement groove441 according to a 16th embodiment is provided on an inner wall surface25 b on the end hard portion 21 side having an object lens 445 of theobject optical system in the accommodation chamber 25 of the therapeuticinstrument elevator base 27.

It is to be noted that the groove width of the guide wire engagementgroove 441 is similarly set as in the 16th embodiment.

Moreover, a guide wall 443 which restricts a protruding direction of thetherapeutic instrument to the end portion on the opposite side to theinner wall surface 25 b on the end hard portion 21 side is provided tothe end portion of the therapeutic instrument elevator base 27. A guideplane 444 for guiding the guide wire 68 to the direction of the guidewire engagement groove 441 is formed on the side of the guide wall 443.

In this embodiment, the following effect can be demonstrated. That is,in this embodiment, the advantage similar to that of the 16th embodimentcan be obtained. In addition to this, since the guide wall 443 forrestricting the protruding direction of the therapeutic instrument tothe end on the opposite side to the inner wall surface 25 b on the endhard portion 21 side is provided to the end portion of the therapeuticinstrument elevator base 27, the therapeutic instrument can be caused toprotrude toward the object lens 445 side of the end hard portion 21 bythe guide wall 443 of the therapeutic instrument elevator base 27 whenraising the therapeutic instrument elevator base 27, thereby improvingthe operability of the therapeutic instrument.

In addition, FIGS. 37A to 37D show an 18th embodiment. In thisembodiment, a guide wire fixing mechanism 381 having a differentstructure substitutes for the wire engagement groove 321 according tothe first embodiment.

That is, a first impetus giving member 382 and a second impetus givingmember 383 for releasably fixing the guide wire 68 when the guide wire68 is in the pinched state are provided to the guide wire fixingmechanism 381 according to this embodiment. As shown in FIG. 37A, thefirst impetus giving member 382 is fixed to the front-side end portionof the channel opening portion 26 of the end hard portion 21 provided atthe end portion 17 of the insertion portion 12 in the endoscope 1.Additionally, the second impetus giving member 383 is provided next tothe first impetus giving member 382 so as to be capable of beingconnected/disconnected to/from the first impetus giving member 382.

Further, a therapeutic instrument guide plane 384 of each of the impetusgiving members 382 and 383 is formed by whittling away those members inaccordance with the therapeutic instrument shape. Furthermore, as shownin FIG. 37B, a guiding protrusion 385 is provided to the second impetusgiving member 383 at a position on the opposite side to the therapeuticinstrument guide plane 384.

Moreover, a guide groove 386 of the second impetus giving member 383 isprovided on a wall surface of the end hard portion 21 on the front side.The guiding protrusion 385 of the second impetus giving member 383 ismovably engaged with the guide groove 386. In addition, the secondimpetus giving member 383 is movably supported substantially verticallywith respect to the lead-in guide path 24 along the guide groove 386.

In addition, a tow wire 387 is provided on the side of the secondimpetus giving member 383 opposed to the first impetus giving member382. A rotatable roller 388 is connected to the end portion of the towwire 387.

Additionally, the base end portion of the tow wire 387 is led to theoperation portion 13 through a tow wire channel 389 and connected to anon-illustrated link mechanism. Further, as in the first embodiment, thetowing operation of the tow wire 387 is enabled by the operation of theoperation lever 72 on the front side.

Further, an accommodation chamber 390 is provided to the first impetusgiving member 382 and the second impetus giving member 383 on theopposite side to the therapeutic instrument guide plane 384. A coil-likespring member 391 for giving impetus in a direction along which thesecond impetus giving member 383 is moved away from the first impetusgiving member 382 is provided in this accommodation chamber 390. Thisspring member 391 is arranged substantially vertically with respect tothe lead-in guide path 24.

Furthermore, in this embodiment, as shown in FIG. 37C, in regard to adistance L1 between the first impetus giving member 382 and the secondimpetus giving member 383 in the usual state, the relationship between awire diameter D1 of the guide wire 68 and an outside diameter D2 of thetherapeutic instrument or any other therapeutic instrument such as theguide catheter is set to “D1<L1<D2”.

Moreover, at the time of towing by the operation lever 72, as shown inFIG. 37D, a distance L2 between the first impetus giving member 382 andthe second impetus giving member 383 when the second impetus givingmember has moved is set to “L2≦D1<D2”.

In addition, a chamfered portion 392 obtained by obliquely cutting acorner portion is provided at a part of the second impetus giving member383 which firstly comes into contact with a roller 388 on the tow wire387 side.

The effect of this embodiment will now be described. When using theendoscope 1 of this embodiment, as in the 29th embodiment, afterinserting the guide catheter and the guide wire 68 into the body throughthe channel 23, the elevator operation knob 48 of the therapeuticinstrument elevator base 27 is operated with the guide catheter beingpulled into the lead-in guide path 24 or the channel 23. The set-up wire30 is towed by the operation of the elevator operation knob 48, and thetherapeutic instrument elevator base 27 is swiveled around the elevatorbase swivel supporting point 28 and raised as indicated by dotted linesin FIG. 37B.

At this moment, when the guide wire 68 is raised by raising thetherapeutic instrument elevator base 27, the guide wire 68 is guidedbetween the first impetus giving member 382 and the second impetusgiving member 383 and fitted therein as shown in FIG. 37C. In thisstate, the roller 388 is pulled next to the second impetus giving member383 through the tow wire 387 by the operation lever 72. As a result, asshown in FIG. 37D, the second impetus giving member 383 is pushed outalong the guide groove 386 and comes close to the first impetus givingmember 382. Therefore, a width of a space between the first impetusgiving member 382 and the second impetus giving member 383 is narrowed,and the guide wire 68 is sandwiched and mechanically fixed.

In addition, after confirming that the guide wire 68 is fixed, the guidecatheter is completely pulled outside the therapeutic instrumentinsertion channel 23 from the operation portion 13 side of the endoscope1.

Thereafter, a therapeutic instrument which is subsequently used isinserted from the base end portion side of the guide wire 68. At thismoment, with the guide wire 68 being used as a guide, the therapeuticinstrument is inserted into the therapeutic instrument insertion channel23. Then, when the therapeutic instrument hustles against the bothimpetus giving members 382 and 383, the tow wire 387 is loosened byoperating the operation lever 72, and the second impetus giving member383 is pushed back to its original position by the force of the springmember 391. Consequently, fixation of the guide wire 68 is released, andthe therapeutic instrument is inserted into a pancreatic/hepatic duct(not shown).

In this embodiment, as in the first embodiment, the guide wire 68 can beeasily fixed by the operation of the operation lever 72 of thefront-side operation portion 13 of the endoscope 1, and the advantagesimilar to that of the first embodiment can be obtained.

Additionally, FIGS. 38 and 39 show a 19th embodiment according to thepresent invention. In this embodiment, a substantially-U-shaped guidewire fixture 121 is provided to the guide plane 29 of the therapeuticinstrument elevator base 27 as shown in FIGS. 38 and 39 in place of thewire engagement grove 321 according to the first embodiment.

As illustrated in FIG. 39, dimensions La and Lb of the guide wirefixture 121 are set to the relationship of “La, Lb>d” with respect tothe outside diameter dimension d of the therapeutic instrument insertionchannel 23.

The effect of this embodiment will now be described. In this embodiment,as in the first embodiment, after inserting the guide wire 68 and theguide catheter into the therapeutic instrument insertion channel 23, theguide catheter is operated to be pulled into the lead-in guide path 24or the channel 23 when the guide wire 68 is fixed. When the guidecatheter enters the channel 23 at the time of removing the guidecatheter, the guide wire 68 is sandwiched between the guide wire fixture121 and the lead-in guide path lower surface 24 a of the end hardportion 21 by raising the therapeutic instrument elevator base 27 byperforming the elevator operation for the therapeutic instrumentelevator base 27, thereby fixing the guide wire 68.

In this embodiment, the therapeutic instrument elevator base 27 israised by the operation by the elevator operation knob 48 on the frontoperation portion 13 side of the endoscope 1, and the guide wire 68 canbe fixed by sandwiching the guide wire 68 between the guide wire fixture121 of the therapeutic instrument elevator base 27 and the lead-in guidepath lower surface 24 a of the end hard portion 21, thereby obtainingthe advantage similar to that of the first embodiment.

Further, in this embodiment in particular, insertion of the therapeuticinstrument in an usual case can not be avoided by the guide wire fixture121 of the therapeutic instrument elevator base 27 by securing theopening portion of the guide wire fixture 121 so as to be wider than thetherapeutic instrument insertion channel 23, and the guide wire 68 canbe fixed by raising the therapeutic instrument elevator base 27.

Furthermore, FIG. 40 shows a 20th embodiment according to the presentinvention. In this embodiment, the structure of the end portion 17 ofthe insertion portion 12 in the endoscope 1 according to the firstembodiment is changed as follows.

That is, an engagement convex portion 341 for fixing the guide wire 68is provided so as to protrude at a peripheral edge part of the channelopening portion 26 of the end cover 22 in place of the wire engagementgroove 331 according to the second embodiment. This engagement convexportion 341 is constituted to be welded to the guide plane 29 of thetherapeutic instrument elevator base 27 with pressure as indicated bydotted lines in FIG. 40 when the therapeutic instrument elevator base 27is raised, and the guide wire 68 is sandwiched between the engagementconvex portion 341 and the therapeutic instrument elevator base 27 sothat the guide wire 68 is releasably engaged.

The effect of this embodiment will now be described. When using theendoscope 1 according to this embodiment, as in the first embodiment,after inserting the guide catheter and the guide wire 68 into the bodythrough the channel 23, the elevator operation knob 48 of thetherapeutic instrument elevator base 27 is operated with the guidecatheter being pulled into the introduction guide path 24 or the channel23. The towing operation of the set-up wire 30 is performed with themanipulation of the elevator operation knob 48, and the therapeuticinstrument elevator base 27 is swiveled around the elevator base swivelsupporting point 28 and raised as indicated by dotted lines in FIG. 40.

Moreover, the guide plane 29 of the therapeutic instrument elevator base27 is welded with pressure to the engagement convex portion 341 providedat the peripheral edge part of the channel opening portion 26 of the endcover 22 when the therapeutic instrument elevator base 27 is raised, andthe guide wire 68 is sandwiched between the engagement convex portion341 and the therapeutic instrument elevator base 27 and releasablyengaged. In this state, the guide wire 68 is mechanically fixed.

In this embodiment, the following advantage can be demonstrated. Thatis, the guide wire 68 can be easily fixed by only the elevator operationof the therapeutic instrument elevator base 27 which is usually carriedout on the front operation portion 13 side of the endoscope 1 in thisembodiment. Therefore, the advantage similar to that of the firstembodiment can be also obtained in this embodiment.

Also, in this embodiment, the structure of the end portion 17 of theinsertion portion 12 can be simplified since a movable type constituentpart does not have to be newly provided at the end portion 17 of theinsertion portion 12 of the endoscope 1, in addition to the advantage ofthe first embodiment.

Additionally, even though the guide wire 68 cannot be pinched because ofthe set-up angle of the therapeutic instrument elevator base 27 in theconventional elevator base 27, if the endoscope 1 adopts the detachableend cover 22 in this embodiment, the guide wire 68 can be fixed byreplacing such a cover with the end cover 22 having a protrudingengagement convex portion 341 for fixing the guide wire 68 to theperipheral edge part of the channel opening portion 26 of the end cover22.

Further, FIGS. 41A and 41B show a 21st embodiment according to thepresent invention. In this embodiment, guide wire fixing means 351having a different structure is provided in place of the wire engagementgroove 32 according to the first embodiment.

That is, a guide wire fixing member 352 for engaging the guide wire 68is provided to the guide wire fixing means 351 according to thisembodiment at a peripheral edge part of the channel opening portion 26of the end hard portion 21. As shown in FIG. 41B, two guide wireidentification members 353 a and 353 b made of stainless steel wireswhich are pendent toward the inner side of the opening portion 26 fromthe both sides of the channel opening portion 26 of the end hard portion21 are provided to the guide wire fixing member 352. The base endportions of the guide wire identification members 353 a and 353 b areembedded in the both side portions of the channel opening portion 26 ofthe end hard portion 21. Furthermore, at least two guide wire fixingmember insertion holes 354 a and 354 b are provided on the both sides ofthe side surface of the channel opening portion 26.

Moreover, one of the two guide wire identification members 353 a and 353b, namely, the first guide wire identification member 353 a is extendedfrom the upper edge side to the inner side of the channel openingportion 26 and bent toward the left side in FIG. 41B. In addition, theother second guide wire identification member 353 b is extended from thelower edge side to the inner side of the channel opening portion 26 andbent toward the right side in FIG. 41B. Respective extended parts 353 a1 and 353 b 1 of the two guide wire identification members 353 a and 353b are arranged so as to be spaced from and opposed to each othersubstantially in parallel. Additionally, a space S having an appropriatewidthwise dimension L is formed between the respective extended parts353 a 1 and 353 b 1 of these guide wire identification members 353 a and353 b. This space S is set so as to be larger than the outside diameterdimension of the guide wire 68, for example.

Further, a guide wire fixture 355 formed by a filate member having noelastic property, e.g., a surgical thread is provided to the guide wirefixing means 351. One end portion of the guide wire fixture 355 is fixedto the first guide wire identification member 353 a on the upper side inFIG. 41B. Furthermore, after passing through the guide wire fixingmember insertion hole 354 a on the upper side (first guide wireidentification member 353 a side) in FIG. 41B of the channel openingportion 26, the guide wire fixture 355 cuts across the opening portion26 and passes through the guide wire fixing member insertion hole 354 bon the lower side (second guide wire identification member 353 b side)in FIG. 41B. Then, the other end portion side of the guide wire fixture355 is fixed to the second guide wire identification member 353 b. As aresult, the guide wire fixture 355 is attached so as to be cross-linkingbetween the both side portions on the opening portion 26.

The effect of this embodiment will now be described. When using theendoscope 1 according to this embodiment, as in the first embodiment,the guide catheter and the guide wire 68 are inserted into the bodythrough the channel 23 and set in such a manner that they protrude fromthe channel opening portion 26 of the end portion 17 in the endoscope 1.In this state, when the therapeutic instrument elevator base 27 israised by operating the elevator operation knob 48 of the operationportion 13 in the endoscope 1, the guide catheter enters the spacebetween the respective extended parts 353 a 1 and 353 b 1 of the guidewire identification members 353 a and 353 b.

At this moment, a material having a larger diameter than that of theguide wire 68, e.g., the guide catheter enlarges the space between therespective extended parts 353 a 1 and 353 b 1 of the guide wireidentification members 353 a and 353 b, and the tensile force of theguide wire fixture 355 hence relaxes. The guide catheter is raisedwithout interfering with the guide wire fixture 355.

Further, when raising the guide wire 68, since the guide wire 68 passesbetween the respective extended parts 353 a 1 and 353 b 1 of the twoguide wire identification members 353 a and 353 b, the tensile force ofthe guide wire fixture 355 fixed to the guide wire identificationmembers 353 a and 353 b does not relax. Therefore, in this case, byraising the therapeutic instrument elevator base 27, the guide wire 68receives the force in the opposite directions by the therapeuticinstrument elevator base 27 and the guide wire fixture 355 in theshearing manner, and the guide wire 68 is hence bent into thesubstantially L shape and fixed.

The following effect can be demonstrated in this embodiment. That is, inthis embodiment, since the guide wire fixing member 352 for engaging theguide wire 68 with the peripheral edge part of the channel openingportion 26 of the end hard portion 21 is provided, the guide wire 68 canbe readily fixed by only the elevator operation for the therapeuticinstrument elevator base 27 which is usually performed by operating theelevator operation knob 48 of the front operation portion 13 of theendoscope 1. Therefore, the advantage similar to that of the firstembodiment can be also obtained in this embodiment.

Furthermore, FIGS. 42 to 44 show a 22nd embodiment according to thepresent invention. In this embodiment, the inner structure of the endportion 17 of the insertion portion 12 in the endoscope 1 according tothe first embodiment is changed as follows.

That is, in this embodiment, a guide wire fixing member accommodationchamber 53 is formed at the end hard portion 21 of the end portion 17 ofthe insertion portion 12 in the endoscope 1. The guide wire fixture 532formed by an insulating member is accommodated in this accommodationchamber 531 so as to be capable of protruding/retracting from/to thelead-in guide path 24 communicating with the channel opening portion 26.The insulating member of the guide wire fixture 532 is used forpreventing sparks caused when the guide wire fixture 532 is accidentallybrought into contact with the endoscope end portion 17 when a highfrequency flows with a papillotomy knife and the like being inserted inthe therapeutic instrument insertion channel 23.

Moreover, as shown in FIG. 44, a substantially-T-shaped guidingprotrusion 533 is provided so as to protrude from the upper portion ofthe guide wire fixture 532. A guide groove 534 having a shapecorresponding to the guiding protrusion 533 is formed at the end hardportion 21. This guide groove 534 is conjugated to the guide wire fixingmember accommodation chamber 531. In addition, the guiding protrusion533 of the guide wire fixture 532 is engaged with the guiding groove 534of the end hard portion 21.

Additionally, a coil-like spring member 535 for giving impetus to theguide wire fixture 532 in the outer direction (direction toward the endof the endoscope 1) of the guide wire fixing member accommodationchamber 531 is provided in this accommodation chamber 531.

Further, the end portion of the tow wire 536 is fixed to the guide wirefixture 532. This tow wire 536 is led to the operation portion 13through the tow wire channel 537 and connected to a non-illustrated linkmechanism. As a result, as in the first embodiment, the towing operationof the guide wire fixture 532 is enabled through the tow wire 536 by theoperation of the operation lever 72 on the front side.

The effect of this embodiment will now be described. In this embodiment,when performing the operation for fixing the guide wire 68 to the endportion 17 of the insertion portion 12 in the endoscope 1 at the time ofreplacing the guide catheter inserted into the body through the guidewire 68 with another therapeutic instrument, as in the first embodiment,the operation for loosening the tow wire 536 is carried out bymanipulating the operation lever 72 with the guide catheter being pulledin the therapeutic instrument insertion channel 23. At this moment, theguide wire fixture 532 is pushed out in the direction toward the end ofthe insertion portion outside the accommodation chamber 531 by thespring force of the spring member 535 and caused to protrude into thelead-in guide path 24 as shown in FIG. 43. Consequently, the guide wire68 raised by the therapeutic instrument elevator base 27 is sandwichedbetween the guide wire fixture 532 and the therapeutic instrumentelevator base 27 and mechanically fixed.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the advantage similar to that of the firstembodiment can be obtained. In addition to this, when performing theoperation for fixing the guide wire 68 to the end portion 17 of theinsertion portion 12 in the endoscope 1, the guide wire 68 can be fixedby the surface contact state between the guide wire fixture 532 and thetherapeutic instrument elevator base 27, thereby further securely fixingthe guide wire 68 as compared with the prior art.

Further, FIG. 45 shows a 23rd embodiment according to the presentinvention. In this embodiment, an index 451 indicative of an insertionposition of the guide catheter 67 is provided to the base end portion ofthe guide catheter 67 according to the seventh embodiment. In thisembodiment, if the guide catheter 67 or the therapeutic instrument isinserted into the therapeutic instrument insertion channel 23 of theendoscope 1, the index 451 of the guide catheter 67 is arranged at aposition corresponding to the insertion opening portion 61 of theoperation portion 13 when the guide catheter 67 or the therapeuticinstrument is drawn to a position at which the guide wire 68 can befixed. Furthermore, the index 451 of the guide catheter 67 may be avisual indicator having a color and the like or an indicator withirregularities that can be touched by a hand to feel.

The effect of this embodiment will now be described. In this embodiment,as in the first embodiment, after inserting the guide catheter 67 intothe therapeutic instrument insertion channel 23 from the insertionopening portion 61 of the operation portion 13 in the endoscope 1, theguide catheter 67 is caused to protrude toward the outside from thechannel opening portion 26 and inserted into a pancreatic/hepatic duct(not shown) in the papillotomy manner.

Then, in the operation for replacing the currently used guide catheter67 with a therapeutic instrument which is subsequently used, the guidewire 68 is first inserted from the mouth ring of the guide catheter 67on the base end side. Thereafter, an observation image (endoscopicimage) of the endoscope 1 is used to confirm that the end portion of theguide wire has entered the pancreatic/hepatic duct (not shown), and thebase end side of the guide wire 68 is gripped by a hand so that theguide wire 68 can not move. Subsequently, in this state, the operationfor pulling out the guide catheter 67 is conducted.

At this moment, the endoscopic image is used to confirm that the guidecatheter 67 has been drawn out from a papilla (not shown), and the guidewire 67 is further pulled out. Then, with the end of the guide catheter67 being accommodated in the channel opening portion 26 at the end ofthe endoscope 1, the index 451 appears on a part of the guide catheterwhich is exposed from the insertion opening portion 61 of the operationportion 13. Therefore, the position of the end of the guide catheter 67can be assuredly confirmed when an operator or a worker sees the index541.

Then, when the state that the end of the guide catheter 67 isaccommodated in the channel opening portion 26 at the end of theendoscope 1 is confirmed, the guide wire 68 can be fixed by operatingthe later-described guide wire fixture 69 and the like.

In this embodiment, the following advantage can be obtained. That is, inthis embodiment, the index 451 indicative of an insertion position ofthe guide catheter 67 is provided at the base end portion of the guidecatheter 67. When the guide catheter 67 or the therapeutic instrument isinserted into the therapeutic instrument insertion channel 23 of theendoscope 1, the index 451 is arranged at a position corresponding tothe insertion opening portion 61 of the operation portion 13 at thepoint in time that the guide catheter 67 or the therapeutic instrumentis pulled to the position at which the guide wire 68 can be fixed.Therefore, the position of the end of the guide catheter 67 can beassuredly confirmed when an operator or a worker sees this index 451,and there is an advantage that the timing for operating the guide wirefixture 69 can be readily acknowledged.

Further, FIGS. 46A and 46B show a 24th embodiment according to thepresent invention. A guide wire fixture 69 formed by a wire which isopened in the loop form and has a snare shape is provided to the notchportion 17 a of the end portion 17 in the endoscope 1. The end openingportion 71 a of the tow wire channel 71 which is inserted into theinsertion portion 12 is provided on a rear end wall surface 17 b of thenotch portion 17 a of the end portion 17. The tow wire 75 for towing theguide wire fixture 69 is inserted into the tow wire channel 71. Further,the base end portion of the guide wire fixture 69 is connected to theend portion of the tow wire 75.

Furthermore, the tow wire 75 is led to the operation portion 13 sidethrough the tow wire channel 71. Moreover, the base end portion of thetow wire 75 is connected to the operation lever (operation transmittingmeans) 72 (see FIG. 1) of the operation portion 13 through the linkmechanism having the same structure as the above-described elevator baseactuation mechanism 41.

Incidentally, since the link mechanism has the same structure as theabove-mentioned elevator base actuation mechanism 41, its explanation isomitted. Moreover, the guide wire fixture 69 is configured to be capableof moving to a protrusion position at which the guide wire fixture iscaused to protrude on the upper surface position of the channel openingportion 26 from the end opening portion 71 a of the tow wire channel 71as shown in FIG. 46A and a accommodation position at which the guidewire fixture 69 is accommodated on the end opening portion 71 a side ofthe tow wire channel 71 as shown in FIG. 46B by the operation of theoperation lever 72.

In addition, when the guide wire fixture 69 protrudes at the uppersurface position of the channel opening portion 26 from the end openingportion 71 a of the tow wire channel 71, the guide wire fixture 69 isopened in the state where the wire is opened in the loop form.

Incidentally, when the guide wire fixture 69 is opened, the guide wirefixture 69 is set so as to have dimensions that it can cover the entirechannel opening portion 26 as shown in FIG. 46 a and be elongated withrespect to the axial direction of the insertion portion 12 in theendoscope 1 in the substantially elliptical shape, and it is configuredto be opened so that the length of the opening portion which is openedin the loop form in the lengthwise direction can be approximately 20 mm.

Additionally, a protrusion 70 capable of temporarily fixing the guidewire fixture 69 on the end side away from the channel opening portion 26is provided to the notch portion 17 a of the end portion 17 in theendoscope 1. Further, by engaging the guide wire fixture 69 with its endportion being hooked on this protrusion 70, the guide wire fixture 69can be held at the standby position.

Further, when operating the operation lever 72 in the operation portion13, the towing operation of the tow wire 75 is effected by the linkmechanism having the same structure as the elevator base actuationmechanism 41, and the guide wire fixture 69 is moved to theaccommodation position at which the guide wire fixture 69 isaccommodated on the end opening portion 71 a side of the tow wirechannel 71 as shown in FIG. 46B. At this moment, an opening area of theloop-like opening portion formed by the wire of the guide wire fixture69 is gradually reduced with the movement of the guide wire fixture 69that the guide wire fixture 69 is pulled to the end opening portion 71 aside of the tow wire channel 71. Furthermore, when a large part of theguide wire fixture 69 is accommodated on the end opening portion 71 aside of the tow wire channel 71, the guide wire 68 which is insertedinto the therapeutic instrument insertion channel 23 and led to theoutside from the channel opening portion 26 as shown in FIG. 46B ispressed against the edge part of the channel opening portion 26 on therear end portion side and fixed.

The effect of this embodiment will now be described. When using theendoscope 1 according to this embodiment, the guide wire fixture 69 ispreviously moved to the protrusion position at which the guide wirefixture 69 is caused to protrude at the upper surface position of thechannel opening portion 26 from the end opening portion 71 a of the towwire channel 71 as shown in FIG. 46A. At this moment, with theloop-shaped opening portion formed by the wire of the guide wire fixture69 being expanded around the channel opening portion 26, the end portionof the guide wire fixture 69 is hooked on the protrusion 70 of the endportion 17 in the endoscope 1 and engaged, thereby holding the guidewire fixture 69 at the standby position.

In this state, the guide catheter 67 is inserted into the therapeuticinsertion channel 23 from the insertion opening portion 61 of theoperation portion 13 in the endoscope 1. Then, the guide catheter 67 iscaused to protrude to the outer side from the channel opening portion 26and inserted into a pancreatic/hepatic duct (not shown) in thepapillotomy manner.

Thereafter, in the operation for replacing the currently used guidecatheter 67 with the therapeutic instrument which is subsequently used,the guide wire 68 is first inserted from the mouth ring of the guidecatheter 67 on the base end side thereof. Then, an observation image(endoscopic image) of the endoscope 1 is used to confirm that the endportion of the guide wire 68 has been inserted into thepancreatic/hepatic duct (not shown), and the base end side of the guidewire 68 is gripped by a hand so that the guide wire 68 can not move.Subsequently, in this state, the operation for pulling out the guidecatheter 67 is performed.

At this moment, after confirming in an endoscopic image that the guidecatheter 67 has been pulled out from a papilla (not shown), the guidecatheter 67 is further pulled out. Then, with the end of the guidecatheter 67 being accommodated in the channel opening portion 26 at theend of the endoscope 1, the end opening portion 71 a of the tow wirechannel 71 is narrowed down as shown in FIG. 46B by towing the guidewire fixture 73 by the operation lever 72, and the guide wire 68 ledfrom the channel opening portion 26 to the outer side is pressed againstthe edge part of the channel opening portion 26 on the rear edge portionside and mechanically fixed.

Moreover, after confirming that the guide wire 68 has been fixed, theguide catheter 67 is completely pulled to the outside of the therapeuticinstrument insertion channel 23 from the operation portion 13 side ofthe endoscope 1.

Then, a therapeutic instrument which is subsequently used is insertedfrom the base end side of the guide wire 68. At this moment, with theguide wire 68 being used as a guide, the therapeutic instrument isinserted into the therapeutic instrument insertion channel 23. Then,when the therapeutic instrument hustles against the guide wire fixture69, fixation of the guide wire 68 by the guide wire fixture 69 isreleased by operating the operation lever 72, and the therapeuticinstrument is inserted into the pancreatic/hepatic duct (not shown).Thereafter, the therapeutic instrument can be replaced by the samemethod for a necessary number of times.

The following advantage can be demonstrated in this embodiment. That is,the guide wire 68 can be readily fixed by the guide wire fixture 69 bythe operation of the operation lever 72 on the front operation portion13 side of the endoscope 1 in this embodiment.

In addition, since the guide wire fixture 69 according to thisembodiment is formed by a snare-shaped wire which is opened in the loopform, secure fixation is enabled by snaring the snare-shaped wire of theguide wire fixture 69 when operating the operation lever 72.

Additionally, in an usual case, accommodating the guide wire fixture 69in the end opening portion 71 a of the tow wire channel 71 can preventthe guide wire fixture 69 from entering the observation visual field ofthe endoscope 1. Thus, this causes no problems.

Further, in this embodiment, the protrusion 70 is provided on the endside away from the channel opening portion 26 of the end portion 17 inthe endoscope 1, and the guide wire fixture 69 can be temporarily fixedto this protrusion. Therefore, as shown in FIG. 46A, the wire of theguide wire fixture 69 can be stably opened in the loop form at theprotrusion position where the guide wire fixture 69 is caused toprotrude at the upper surface position of the channel opening portion 26from the end opening portion 71 a of the tow wire channel 71.

Incidentally, although this embodiment has illustrated the structure foreffecting the towing operation of the tow wire 75 by the operation lever72 of the operation portion 13 through the link mechanism as an exampleof the operation of the guide wire fixture 69, the present invention isnot restricted thereto. Any other means may be used if the guide wirefixture 69 can be led in the axial direction of the insertion portion 12of the endoscope 1. For example, an operator manually tows a part of thetow wire 75 of the guide wire fixture 69 protruding from the operationportion 13 to the outer side.

Furthermore, FIGS. 47A and 47B show a 25th embodiment according to thepresent invention. In this embodiment, the structure is changed so thata guide wire fixture 73 having a hook-like guide wire engagement portion73 a is provided as shown in FIGS. 47A and 47B in place of thesnare-shaped wire which is opened in the loop form as in the guide wirefixture 69 according to the 24th embodiment.

The end portion of the tow wire 75 according to the 24th embodiment isfixed to the base end portion of the guide wire fixture 73. Moreover, aguide wire engagement portion 73 a is formed at the end portion of theguide wire fixture 73.

The effect of this embodiment will now be described. In an usual casewhen using the endoscope 1 according to this embodiment, the guide wirefixture 73 is towed to the front side by the operation lever 72 andaccommodated in the end opening portion 71 a of the tow wire channel 71.

In addition, when fixing the guide wire 68, the operation lever 72 isused to cause the guide wire fixture 73 to protrude from the end openingportion 71 a of the tow wire channel 71 as shown in FIG. 47A. Then, theguide wire engagement portion 73 a of the guide wire fixture 73 ishooked on the guide wire 68. Subsequently, in this state, the operationlever 72 is used to tow the guide wire fixture 73 toward the front side.As a result, as shown in FIG. 47B, the guide wire 68 led to the outerside from the channel opening portion 26 is pressed against the edgepart of the channel opening portion 26 on the rear end portion side andmechanically fixed by the guide wire engagement portion 73 a of theguide wire fixture 73.

In this embodiment, the following advantage can be demonstrated. Thatis, as in the 24th embodiment, the guide wire 68 can be also easilyfixed using the guide wire fixture 73 by the manipulation by theoperation lever 72 on the front operation portion 13 side of theendoscope 1 in this embodiment, and the advantage similar to that of the24th embodiment can be obtained.

Further, in this embodiment in particular, since the guide wire fixture73 including the guide wire engagement portion 73 a having a hook shapeis provided, it is not necessary to set the state in which the loop-likeopening portion formed by the wire of the guide wire fixture 69 isopened as in the 24th embodiment when inserting the guide catheter 67into the therapeutic instrument insertion channel 23 from the insertionopening portion 61 of the operation portion 13 of the endoscope 1.Therefore, the guide wire 68 can be readily fixed by the manipulation ofthe operation lever 72 on the front side only when fixing the guide wire68, and hence the operability of the endoscope 1 can be furtherimproved.

Furthermore, FIGS. 48 to 50 show a 26th embodiment according to thepresent invention. In this embodiment, the structure of the end portion17 of the endoscope 1 according to the 25th embodiment is changed asfollows.

That is, in this embodiment, as shown in FIG. 48, the end openingportion 71 a of the tow wire channel 71 is provided on the end portionside away from the channel opening portion 26 in the notch portion 17 aof the end portion 17 in the endoscope 1, and the guide wire fixture 73according to the 25th embodiment is caused to protrude from the endopening portion 71 a on the end portion side away from the channelopening portion 26.

Moreover, to the end hard portion 21 is formed the tow wire channel 71which is bent into the substantially L shape along the lower surfaceside and the left end portion (end portion) in the accommodation chamber25 of the therapeutic instrument elevator base 27 in FIG. 49 and FIG.50. In addition, the end opening portion 71 a of the tow wire channel 71is arranged on the notched surface of the notch portion 17 a of the endportion 17.

Additionally, the guide wire fixture 73 having a hook shape according tothe 25th embodiment is inserted into the tow wire channel 71. The baseend portion of the guide wire fixture 73 is led to the operation portion13 side as in the 24th embodiment and connected to the operation lever72 through the link mechanism. Since this link mechanism has the samestructure as the above-described elevator base actuation mechanism 41,its explanation is omitted.

The effect of this embodiment will now be described. In the endoscope 1according to this embodiment, the guide wire fixture 73 having a hookshape protrudes from the end opening portion 71 a on the end portionside away from the channel opening portion 26 in the notch portion 17 aof the end portion 17 in the endoscope 1 at the time of manipulation ofthe operation lever 72.

Further, with the guide wire engagement portion 73 a of the guide wirefixture 73 being hitched to the guide wire 68, by towing the guide wirefixture 73 to the front side by the operation lever 72, the guide wire68 led to the outer side from the channel opening portion 26 can bepressed against the edge portion side of the end opening portion 71 a onthe end portion side away from the channel opening portion 26 andmechanically fixed by the guide wire engagement portion 73 a of theguide wire fixture 73 as shown in FIG. 50.

Furthermore, in this embodiment, as shown in FIG. 50, with the guidewire 68 being hooked by the guide wire engagement portion 73 a of theguide wire fixture 73, by raising the therapeutic instrument elevatorbase 27, the tension from the guide wire fixture 73 and the thrustingforce from the therapeutic instrument elevator base 27 act on the guidewire 68 in the opposed directions in the shearing manner. Therefore,upon receiving the force in the opposed directions, the guide wire 68 isbent in to the substantially L shape, and the guide wire 68 can be hencefirmly fixed to the end portion 17 of the endoscope 1.

In this embodiment, as in the first and 25th embodiments, the guide wire68 can be easily fixed using the guide wire fixture 73 by themanipulation of the operation lever 72 on the front operation portion 13side of the endoscope 1, and the advantage similar to that of the 24thembodiment can be obtained.

Moreover, in this embodiment in particular, since the end openingportion 71 a of the tow wire channel 71 is provided on the end portionside away from the channel opening portion 26 in the notch portion 17 aof the end portion 17 of the endoscope 1, the tension from the guidewire fixture 73 and the thrusting force from the therapeutic instrumentelevator base 27 can act on the guide wire 68 in the opposed directionsin the shearing manner by raising the therapeutic instrument elevatorbase with the guide wire 68 being hooked by the guide wire engagementportion 73 a of the guide wire fixture 73. Therefore, upon receiving theforce in the opposed directions, the guide wire 68 can be bent in to thesubstantially L shape and firmly fixed in this state. Accordingly, thereis the advantage that the guide wire 68 can be further securely fixed tothe end portion 17 of the endoscope 1 as compared with the case wherethe guide wire fixture 73 having a hook shape is caused to protrude fromthe front side of the channel opening portion 26 as in the 25thembodiment.

In addition, FIG. 52 and FIGS. 54A to 54B show a 27th embodimentaccording to the present invention. In this embodiment, a guide wireengagement member 422 having a hook shape which is driven to rotate by arotary operation mechanism 421 formed by rack and pinion gears isprovided in place of the guide wire engagement portion 73 a having ahook shape in the guide wire fixture 73 which is driven to move forwardand backward along the towing direction of the two wire 75 as in the25th embodiment.

As shown in FIG. 54A, a guide wire engagement portion 424 having a hookshape is provided at the end portion of an elongated arm portion 423 inthe guide wire engagement member 422. Further, a pinion gear 425 isprovided to the base end portion of the arm portion 423.

Furthermore, as shown in FIG. 54B, a rack gear 426 is fixed to the endportion of the tow wire 75 according to the 25th embodiment. The rackgear 426 of the tow wire 75 is meshed with the pinion gear 425 of theguide wire engagement member 422 as shown in FIG. 52. Moreover, therotary operation mechanism 421 consisting of rack and pinion gears isformed by the pinion gear 425 and the rack gear 426 of the guide wireengagement member 422.

In addition, as shown in FIG. 53, an engagement member accommodationchamber 428 for accommodating the guide wire engagement member 422 isformed at the end opening portion 71 a of the tow wire channel 71 in theend hard portion 21 of the endoscope 1.

It is to be noted that the end portion of the tow channel 71 isconnected to a connection pipe 71 b fitted in to a channel hole formedto the end hard portion 21. Further, a bearing portion 427 whichrotatably supports the pinion gear 425 of the guide wire engagementmember 422 is provided to the engagement member accommodation chamber428. Furthermore, the pinion gear 425 of the guide wire engagementmember 422 is rotatably supported by a support shaft 427 a (shown inFIG. 52) of the bearing portion 427.

The fixing position of the pinion gear 425 of the guide wire engagementmember 422 is arranged on the side end of the engagement memberaccommodation chamber 428 in such a manner that the guide wire 68 whichprotrudes from the channel opening portion 26 of the end portion 17 ofthe endoscope 1 can be grabbed by the guide wire engagement portion 424having a hook shape.

The effect of this embodiment will now be described. In this embodiment,the guide wire engagement member 422 is usually held at the standbyposition that the guide wire engagement portion 424 having a hook shapeis moved to the rear end portion of the channel opening portion 26 asindicted by solid lines in FIG. 52. Moreover, by pulling the tow wire 75to the front side by the manipulation of the operation lever 72 of theoperation portion 13, the guide wire engagement member 422 is driven torotate by the rotary operation mechanism 421 consisting of the rack andthe pinion. At this moment, when the guide wire engagement portion 424having a hook shape cuts across the channel opening portion 26, theguide wire 68 is grabbed by the guide wire engagement portion 424 havinga hook shape, and the guide wire 68 is led to the direction of the sidewall of the end hard portion 21. In this state, when the guide wireengagement member 422 further rotates, the guide wire 68 is held betweenthe side wall of the end hard portion 21 and the guide wire engagementportion 424, thereby fixing the guide wire 68.

In addition, when releasing fixation of the guide wire 68, the guidewire engagement member 422 rotates in the opposite direction byreturning the operation lever 72 of the operation portion 13 to itsoriginal position, and the guide wire engagement portion 424 having ahook shape returns to the standby position that the guide wireengagement portion 424 having a hook shape is moved to the rear endposition of the channel opening portion 26 as indicated by solid linesin FIG. 52. As a result, the guide wire 68 comes off the guide wireengagement portion 424 having a hook shape, and fixation of the guidewire 68 is released.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, as in the 25th embodiment, the guide wire 68 can bereadily fixed by the guide wire engagement member 422 by themanipulation of the operation lever 72 on the front operation portion 13side of the endoscope 1, and the guide wire 68 does not have to begripped on the operation portion 13 side of the endoscope 1 as in theprior art. Therefore, the operation for replacing the therapeuticinstrument is facilitated, and the operation time required for replacingthe therapeutic instrument can be hence shortened.

In addition, since the guide wire engagement member 422 including theguide wire engagement portion 424 having a hook shape is provided inthis embodiment, the guide wire 68 can be easily fixed by themanipulation of the operation lever 72 on the front side only whenfixing the guide wire 68. Therefore, the operability of the endoscope 1can be further enhanced.

Additionally, in this embodiment in particular, since the elongated armportion 423 of the guide wire engagement member 422 is not deeply pulledinside the end hard portion 21, the depth of the engagement memberaccommodation chamber 428 is reduced. Thus, a brush/cleaning fluid caneasily spread inside the engagement member accommodation chamber 428 atthe time of cleaning the endoscope 1, and the operability duringcleaning/sterilization can be improved.

Further, in case of guiding the guide wire 68 in the direction of theside wall of the end hard portion 21 by the guide wire engagementportion 424 having a hook shape, when the guide wire 68 enters thevisual field, it can be advantageously readily confirmed that the guidewire 68 is fixed.

It is to be noted that, as in a modification of the 27th embodimentillustrated in FIG. 55, the arm portion 423 of the guide wire engagementmember 422 and the guide wire engagement portion 424 having a hook shapeat the end portion of the arm portion 423 may be formed by separatemembers and a friction reinforcement member 429 having the largefriction resistance may be used for only the guide wire engagementportion 424 having a hook shape.

Furthermore, FIGS. 56A and 56B show a 28th embodiment according to thepresent invention. In this embodiment, the guide wire engagement member422 according to the 27th embodiment is changed as follows.

That is, in the guide wire engagement member 431 according to thisembodiment, as shown in FIG. 56B, a ring-like shaft fixing portion 432is provided to the base end portion of the arm portion 423 which issimilar to that of the guide wire engagement member 422 according to the27th embodiment. One end portion of the support shaft 433 is fixed tothe shaft fixing portion 432. A pinion gear 434 is fixed to the otherend portion of the support shaft 433. Moreover, an O ring 435 forsealing is fitted on the outer peripheral surface of the support shaft433 between the shaft fixing portion 432 and the pinion gear 434 of theguide wire engagement member 431.

In addition, as shown in FIG. 56A, a gear portion accommodation chamber436 is additionally provided below the engagement member accommodationchamber 428 in the end hard portion 21 of the endoscope 1. Additionally,the shaft fixing portion 432 of the guide wire engagement member 431 isaccommodated in the engagement member accommodation chamber 428 and thepinion gear 434 is housed in the gear portion accommodation chamber 436,respectively, in the end hard portion 21. Further, a sliding plane 637coming in to contact with the O ring 435 is formed in the communicationpath between the engagement member accommodation chamber 428 and thegear portion accommodation chamber 436. Furthermore, this O ring 435assures the water-tightness between the engagement member accommodationchamber 428 and the gear portion accommodation chamber 436.

Moreover, the end portion of the channel hole of the tow wire channel 71which is formed at the end hard portion 21 is caused to communicate withthe gear portion accommodation chamber 436. In addition, the rack gear426 at the end portion of the tow wire 75 is meshed with the pinion gear434 in the gear portion accommodation chamber 436.

Additionally, the guide wire engagement member 431 according to thisembodiment is driven to rotate by the operation similar to that of the27th embodiment through the meshed portion between the rack gear 426 atthe end portion of the tow wire 75 and the pinion gear 434 in the gearaccommodation chamber 436.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, as in the 27th embodiment, the guide wire 68 can bereadily fixed using the guide wire engagement member 431 by themanipulation of the operation lever 72 on the front operation portion 13side of the endoscope 1, and the guide wire 68 does not have to begripped on the operation portion 13 side of the endoscope 1 as in theprior art. Therefore, since the operation for replacing the therapeuticinstrument is facilitated, there is the advantage that the operationtime required for replacing the therapeutic instrument can be shortened.

Further, in this embodiment, the gear portion accommodation chamber 436is additionally provided below the engagement member accommodationchamber 428 in the end hard portion 21 of the endoscope 1, and the Oring 435 is used to assure the water-tightness between the engagementmember accommodation chamber 428 and the gear portion accommodationchamber 436. Therefore, dirt, etc does not enter the gear portionaccommodation chamber 436 configured to have a complicated shape and thetow wire channel 71. Thus, in addition to the advantage of the 27thembodiment, there is the advantage that the cleaning/sterilizationproperty can be further improved.

Furthermore, FIGS. 57A, 57B and 57C show a 29th embodiment according tothe present invention. In this embodiment, the end portion 17 of theendoscope 1 according to the first embodiment is changed as follows.

The structure of the end portion 17 of the endoscope 1 will now bedescribed with reference to FIG. 57A. A guide wire fixing elevator base26 is provided on the lower surface of the lead-in guide path 24 in theend hard portion 21 at the end portion 17 of the endoscope 1. One endportion of the guide wire fixing elevator base 267 is pivoted withrespect to the end hard portion 21 by the elevator base swivelsupporting point 268. This elevator base swivel supporting point 268 isarranged at a lower part of the end opening portion of the lead-in guidepath 24. Moreover, the guide wire fixing elevator base 267 is attachedso as to be capable of a derricking motion in such a manner that itswivels around the elevator base swivel supporting point 268 from thestandby position indicated by solid lines in FIG. 57A to the set-upposition indicated by dotted lines in the same drawing in theintroduction guide path 24.

Moreover, the end portion of the tow wire 269 is fixed to the other endportion of the guide wire fixing elevator base 267 as shown in FIG. 57B.The tow wire 269 is led to the operation portion 13 through the tow wirechannel 274.

In addition, a non-illustrated link mechanism for operating the tow wire269 of the guide wire fixing elevator base 267 is included in theoperation portion 13. Since this link mechanism has the same structureas the elevator base actuation mechanism 41, the explanation thereof isomitted. Additionally, the tow wire 269 is operated to be towed bymanipulation of the operation lever 72 in the operation portion 13through the arm 49, the link member 44 and the wire mixing member 42,which have the link mechanism similar to the elevator base actuationmechanism 41, in sequence as in the therapeutic instrument elevator base27, and the derricking motion of the guide wire fixing elevator base 267is performed around the elevator base swivel supporting point 268. As aresult, as shown in FIG. 57C, the guide wire 68 which is inserted in tothe therapeutic instrument insertion channel 23 and led to the outerside from the channel opening portion 26 is fixed by raising the guidewire fixing elevator base 267.

It is to be noted that means for actuating the guide wire fixingelevator base is not restricted to this embodiment as long as it can towthe guide wire fixing elevator base 267.

Further, on the guide plane 275 of the guide wire fixing elevator base267, steps are reduced as much as possible so that the channel 23 andthe guide plane 29 of the therapeutic instrument elevator base 27 can besmoothly connected when the guide wire fixing elevator base 267 islowered.

It is to be noted that, assuming that the length of the guide wirefixing elevator base 267 is L and the diameter of the lead-in guide path24 is D as shown in FIG. 57B, the dimensional relationship of the guidewire fixing elevator base 267 is set to “D≦L”.

The effect of this embodiment will now be described. When using theendoscope 1 according to this embodiment, the guide wire fixing elevatorbase 267 is held at the standby position shown in FIG. 57B in advance.

In this state, the guide catheter 67 is inserted in to the therapeuticinstrument insertion channel 23 from the insertion opening portion 61 ofthe operation portion 13 in the endoscope 1. Then, the guide catheter 67is caused to protrude to the outer side from the channel opening portion26 and inserted in to a pancreatic/hepatic duct (not shown) in thepapillotomy manner. At this moment, since the guide plane 275 of theguide wire fixing elevator base 267, the channel 23 and the therapeuticinstrument elevator base 27 are smoothly connected to each other, theguide catheter 67 can be inserted without being caught.

Thereafter, when replacing the currently used guide catheter 67 with atherapeutic instrument which is subsequently used, the guide wire 68 isfirst inserted from the mouth ring on the base end side of the guidecatheter 67. Then, an observation image (endoscopic image) of theendoscope 1 is used to confirm that the end portion of the guide wire 68has entered the pancreatic/hepatic duct (not shown), and the base endside of the guide wire 68 is gripped by a hand in such a manner that theguide wire 68 can not move. Subsequently, the operation for pulling outthe guide catheter 67 is conducted in this state.

At this moment, after an endoscopic image is used to confirm that theguide catheter 67 has been pulled from a papilla (not shown), the guidecatheter 67 is further pulled out. Then, with the end of the guidecatheter 67 being housed in the therapeutic instrument insertion channel23, the guide wire fixing elevator base 267 is swiveled to the set-upposition indicated by solid lines in FIG. 57A by towing the two wire 269using the operation lever 72. Consequently, as shown in FIG. 57C, theguide wire 68 led to the outer side from the channel opening portion 26is sandwiched between the upper surface 273 of the lead-in guide path 24of the end hard portion 21 and the guide wire fixing elevator base 267and mechanically fixed.

Furthermore, after confirming that the guide-wire 68 is fixed, the guidecatheter 67 is completely pulled to the outside of the therapeuticinstrument insertion channel 23 from the operation portion 13 side ofthe endoscope 1.

Then, a therapeutic instrument which is subsequently used is insertedfrom the base end portion side of the guide wire 68. At this moment,with the guide wire 68 being used as a guide, the therapeutic instrumentis inserted in to the therapeutic instrument insertion channel 23.Moreover, when the therapeutic instrument hustles against the guide wirefixing elevator base 267, fixation by the guide wire fixing elevatorbase 267 is released by manipulating the operation lever 72, and thetherapeutic instrument is inserted in to the pancreatic/hepatic duct(not shown).

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the guide wire 68 can be easily fixed by operatingthe guide wire fixing elevator base 267 by using the operation lever 72on the front operation portion 13 side of the endoscope 1. In addition,in case of fixing the guide wire 68, secure fixation is enabled byholding the operation lever 72 at the operation position.

Additionally, in an usual case, by setting down the guide wire fixingelevator base 267 to the standby position shown in FIG. 57B, thetherapeutic instrument can be inserted without any problem since theintroduction guide path 24 of the end hard portion 21 is opened.

Further, since conventional therapeutic instruments can be used as theyare in this embodiment, the excellent operability can be maintained byusing an operator's favorite therapeutic instrument. Therefore, thetherapeutic instrument can be replaced in a shorter time withoutdeteriorating the conventional method for operating the therapeuticinstrument or the operation sense.

Furthermore, since the guide wire 68 can be fixed by the guide wirefixing elevator base 267 at the end portion 17 of the insertion portion12, the length of the guide wire 68 can be shortened. Accordingly, thereis the advantage that rolling and handling of the guide wire 68 can befacilitated and a large working space is no longer necessary. Moreover,replacement of the therapeutic instrument can be facilitated and thenumber of assistants can be reduced, which advantageously leads to adecrease in the time of operation.

In addition, in order to increase the fixation strength by the frictionresistance on the guide wire contact surface of the guide wire fixingelevator base 267 in the endoscope 1 according to the 29th embodiment,an elastic member 276 may be provided to the guide wire fixing elevatorbase 267 as in the first modification shown in FIG. 59A or a protrusion277 may be provided on the guide wire contact surface of the guide wirefixing elevator base 267 as in the second modification shown in FIG. 59as long as insertion of the therapeutic instrument is not interfered.

Additionally, FIGS. 58A to 58C show 30th embodiment according to thepresent invention. In this embodiment, the structure of the therapeuticinstrument elevator base 27 and the guide wire fixing elevator base 267in the endoscope 1 according to the 29th embodiment is changed asfollows.

That is, in this embodiment, as shown in FIG. 58A, a platy guide wirefixing elevator base 282 is provided so as to be superimposed on thetherapeutic instrument elevator base 281. As shown in FIG. 58B, in thetherapeutic instrument elevator base 281, an attachment concave portion284 of the guide wire fixing elevator base 282 is provided to aswiveling portion in the vicinity of the elevator base swivel supportingpoint 283.

Further, as shown in FIG. 58C, a bearing portion 285 is formed on oneend side portion side of the guide wire fixing elevator base 282. Thisbearing portion 285 is inserted in to the concave portion 284 of thetherapeutic instrument elevator base 281 so as to be capable ofswiveling. Furthermore, the swivel supporting point 286 of the guidewire fixing elevator base 282 is provided coaxially with the swivelsupporting point 283 of the therapeutic instrument elevator base 281.

It is to be noted that the swivel supporting point 286 of the guide wirefixing elevator base 282 and the swivel supporting point 283 of thetherapeutic instrument elevator base 281 may have different axes.

Moreover, the end portion of the tow wire 269 according to the 29thembodiment is fixed to the side surface of the guide wire fixingelevator base 282. The tow wire 269 is led to the operation portion 13through the tow wire channel 274 and connected to a non-illustrated linkmechanism. In addition, the towing operation of the guide wire fixingelevator base 282 is enabled through the tow wire 269 by manipulatingthe operation lever 72 on the front side as in the 29th embodiment.

It is to be noted that an elastic member 276 shown in FIG. 59A or aprotrusion 277 shown in FIG. 59B may be provided on the top face of theguide wire fixing elevator base 282 as in the 29th embodiment.

Additionally, in this embodiment, by towing the tow wire 269 by theoperation lever 72, the guide wire fixing elevator base 282 is swiveledto the set-up position. Consequently, the guide wire 68 which is led tothe outer side from the channel opening portion 26 is sandwiched betweenthe upper surface 273 of the lead-in guide path 24 of the end hardportion 21 and the guide wire fixing elevator base 282 and mechanicallyfixed.

The following advantage can be demonstrated in this embodiment. That is,the guide wire 68 can be also releasably fixed at the end portion 17 ofthe insertion portion 12 in the endoscope 1 by using the guide wirefixing elevator base 282 when the tow wire 269 is towed by the operationlever 72, thereby obtaining the advantage similar to that of the 29thembodiment. Further, in this embodiment in particular, since a platyguide wire fixing elevator base 282 is provided so as to be superimposedon the therapeutic instrument elevator base 281, a space for installingthe guide wire fixing elevator base 282 does not have to be solelyprovided, thereby further saving the space.

Furthermore, FIG. 60A and FIGS. 60B to 62 show a 31st embodimentaccording to the present invention. In this embodiment, the structure ofthe 29th embodiment is changed so that the guide wire fixing elevatorbase 267 is incorporated in the therapeutic instrument elevator base 27.

That is, as shown in FIGS. 61A and 61B, an opening portion 293 foraccommodating incorporated components is provided on the guide plane 291a of the therapeutic instrument elevator base 291 according to thisembodiment. In this opening portion 293 are housed a guide wire fixingelevator base 292 and an elevator base moving member 295 according tothis embodiment.

The elevator base swivel supporting point 294 of the guide wire fixingelevator base 292 is coaxially pivoted together with the swivelsupporting point 294 of the therapeutic instrument elevator base 291.

It is to be noted that the elevator base swivel supporting point 294 ofthe guide wire fixing elevator base 292 may have an axis different fromthat of the swivel supporting point 294 of the therapeutic instrumentelevator base 291.

Moreover, the elevator base moving member 295 is provided at a positionon the end side of the endoscope 1 away from the guide wire fixingelevator base 292. The end portion of the tow wire 269 according to the29th embodiment is fixed to the elevator base moving member 295. The towwire 269 is led to the operation portion 13 through the tow wire channel274 and connected to a non-illustrated link mechanism. In addition, asin the 29th embodiment, the towing operation of the tow wire 269 can beeffected by manipulating the operation lever 72 on the front side.

It is to be noted that the elevator base moving member 295 is usuallyheld at the standby position arranged ahead away from the guide wirefixing elevator base 292 as shown in FIG. 60A. In this state, the guidewire fixing elevator base 292 is held at the standby position where theguide wire fixing elevator base 292 is lowered.

Additionally, when towing the elevator base moving member 295, as shownin FIG. 60B, the elevator base moving member 295 is configured to moveto the front side and pushes the guide wire fixing elevator base 292. Asa result, the guide wire fixing elevator base 292 swivels around theelevator base swivel supporting point 294 and swivels to the set-upposition shown in FIG. 60B. At this moment, the guide wire fixingelevator base 292 is set to a height corresponding to the upper surface297 of the lead-in guide path 24 of the end hard portion 21.

It is to be noted that the guide planes 291 a and 298 are smoothlyconnected to each other without making irregularities when thetherapeutic instrument elevator base 291 and the guide wire fixingelevator base 292 are lowered.

Further, an R bending portion 300 is formed by cutting the edge of theback surface portion of the guide wire fixing elevator base 292 so thatthe elevator base moving member 295 can easily move to the back surfaceside of the guide wire fixing elevator base 292. Furthermore, in orderto reduce the friction resistance of the guide plane 298 of the guidewire fixing elevator base 292, a material of the elevator base movingmember 295 may be changed from metal to plastic.

Moreover, in this embodiment, as shown in FIG. 62, the relationshipbetween a set-up angle θ1 of the therapeutic instrument elevator base291 and an elevator base θ2 of the guide wire fixing elevator base 292is set to “θ1<θ2”.

The effect of this embodiment will now be described. When using theendoscope 1 according to this embodiment, as in the 29th embodiment,with the guide catheter 67 being pulled in the lead-in guide path 24 orthe channel 23, the operation for raising the guide wire fixing elevatorbase 292 is performed. In such a case, in this embodiment, by towing theelevator base moving member 295 by using the operation lever 72, theelevator base moving member 295 moves below the guide wire fixingelevator base 292 and sets up the guide wire fixing elevator base 292.Then, the guide wire 68 is sandwiched between the guide wire fixingelevator base 292 and the upper surface 297 of the lead-in guide path 24of the end hard portion 21, and the guide wire 68 is fixed.

In this embodiment, since the guide wire fixing elevator base 292 andthe elevator base moving member 295 are accommodated in the openingportion 293 of the therapeutic instrument elevator base 291, theadvantage similar to that of the 30th embodiment can be obtained. Inaddition to the advantage of the 30th embodiment, the guide wire 68 canbe fixed by the guide wire fixing elevator base 292 which isdimensionally smaller than the therapeutic instrument elevator base 291since the relationship between the set-up angle θ1 of the therapeuticinstrument elevator base 291 and the set-up angle θ2 of the guide wirefixing elevator base 292 is set to “θ1<θ2” in this embodiment inparticular.

Further, as in the modification of the guide wire fixing elevator base292 in the endoscope 1 according to the 31st embodiment shown in FIG.63, a roller 299 may be provided on the back surface of the guide wirefixing elevator base 292 or the guide plane 298 of the elevator basemoving member 295 so that the friction resistance between the backsurface of the guide wire fixing elevator base 292 and the guide plane298 of the elevator base moving member 295 can be reduced.

Furthermore, FIGS. 64 and 65 show a 32nd embodiment according to thepresent invention. In this embodiment, a guide wire fixing elevator base301 having a different structure is provided in place of the guide wirefixing elevator base 267 in the endoscope 1 according to the 29thembodiment.

That is, as shown in FIG. 64, at the end portion 17 of the insertionportion 12 in the endoscope 1 according to this embodiment, the guidewire fixing elevator base 301 is provided on the rear end wall surface17 b of the notch portion 17 a. This guide wire fixing elevator base 301is arranged at a part opposed to the therapeutic instrument elevatorbase 27 in the channel opening portion 26.

Moreover, one end portion of the guide wire fixing elevator base 301 ispivoted to the end hard portion 21 of the end portion 17 so as to becapable of swiveling through a swivel supporting point 302. In addition,the end portion of the tow wire 303 is fixed on the other end side ofthe guide wire fixing elevator base 301. The base end portion of the towwire 303 is led to the operation portion 13 and connected to anon-illustrated link mechanism. Additionally, the operation for towingthe guide wire fixing elevator base 301 is enabled by manipulation ofthe operation lever 72 on the front side through the tow wire 303 as inthe 29th embodiment.

It is to be noted that the elastic member 276 shown in FIG. 59A or theprotrusion 277 shown in FIG. 59B may be provided on a top face 301 a ofthe guide wire fixing elevator base 301 as in the 29th embodiment.

The effect of this embodiment will now be described. In an usual case,when the guide wire fixing elevator base 301 is pushed out by theoperation lever 72, the guide wire fixing elevator base 301 can swivelwith the guide wire fixing elevator base swivel supporting point 302 asa base point as indicated by a dotted line in FIG. 65, and insertion ofthe therapeutic instrument can be performed without any problem in anusual case.

Further, in this embodiment, the guide wire fixing elevator base 301 isswiveled in a direction along which it comes in to contact with thetherapeutic instrument elevator base 27 side as indicated by solid linesin FIG. 65 by towing the two wire 303 by using the operation lever 72.As a result, the guide wire 68 led from the channel opening portion 26to the outer side is sandwiched between the guide wire fixing elevatorbase 301 and the therapeutic instrument elevator base 27 andmechanically fixed, and the guide wire 68 can be fixed as in the 29thembodiment.

Since the guide wire 68 can be likewise fixed by the guide wire fixingelevator base 301 in this embodiment as in the 29th embodiment, theadvantage similar to the 29th embodiment can be also obtained in thisembodiment.

Furthermore, FIGS. 66A to 66D show a 33rd embodiment according to thepresent invention. In this embodiment, an operation mechanism for theguide wire fixing elevator base 267, which has a different structure, isprovided in place of the operation lever 72 for the guide wire fixingelevator base 267 in the operation portion 13 of the endoscope 1according to the 29th embodiment.

That is, as shown in FIG. 66A, to the operation portion 13 of theendoscope 1 according to this embodiment is provided a tow knob 264 foroperation which is formed in to a substantially cylindrical shapebetween a grip 262 for holding the operation portion 13 and a bendprevention portion 263 below the insertion portion 61. This tow knob 264is rotatably fitted to the base 47 as a base board of the operationportion 13 as shown in FIG. 66C. Moreover, a rotary shaft 01 of the towknob 264 is coaxial with the central axis 02 of the insertion portion12.

Incidentally, the rotary shaft of the elevator operation knob 48 of thetherapeutic instrument elevator base 27 is coaxial with the curvedoperation portion 56, and hence it exists orthogonally with respect tothe central shaft 02 of the insertion portion 12. Moreover, the rotaryshaft 01 of the tow knob 264 exists at a position orthogonal to therotary shaft of the elevator operation knob 48.

In addition, as shown in FIG. 66C, a cylindrical cam member 265 isembedded in the two knob 264. As shown in FIG. 66D, a cam groove 265 ais obliquely provided to this cam member 26S. A moving pin 266 isengaged with the cam groove 265 a of the cam member 265 so as to becapable of moving along the cam groove 265 a.

Additionally, the base end portion of the tow wire 269 inserted in tothe tow wire channel 274 is fixed to the moving pin 266. When the movingpin 266 moves along the cam groove 265 a of the cam member 265 with therotating operation of the tow know 264, the two wire 269 movesforward/backward along the direction of the central axis O2 of theinsertion portion 12 through the moving pin 266.

The effect of this embodiment will now be described. When using theendoscope 1 according to this embodiment, if the guide wire fixingelevator base 267 is towed, the tow knob 264 is rotated. At this moment,since the cam member 265 also rotates integrally with the tow knob 264,the moving pin 266 moves in the cam groove 265 a with rotation of thecam member 265, and the guide wire fixing elevator base 267 is operatedto be towed by towing the tow wire 269.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the guide wire 68 can be easily fixed at the endportion 17 of the insertion portion 12 of the endoscope 1 by theoperation of the tow knob 264 on the front operation portion 13 side ofthe endoscope 1 as in the 29th embodiment, and the advantage similar tothat of the 29th embodiment can be obtained.

Additionally, in this embodiment in particular, since the rotary shaft01 of the tow knob 264 of the guide wire fixing elevator base 267 existsat a position orthogonal to the rotary shaft of the elevator operationknob 48 of the therapeutic instrument elevator base 27, the operationdirection of the elevator operation knob 48 of the therapeuticinstrument elevator base 27 is different from the operation direction ofthe tow knob 264 of the guide wire fixing elevator base 267. Therefore,it is possible to prevent occurrence of an erroneous operation that theelevator operation knob 48 of the therapeutic instrument elevator base27 and the tow knob 267 of the guide wire fixing elevator base 267 aremixed up and actuated.

Further, since the insertion opening of the guide wire 68 and the towknob 264 of the guide wire fixing elevator base 267 can get close toeach other by providing the tow knob 264 of the guide wire fixingelevator base 267 to a position in the vicinity to the insertion openingportion 61, the operability can be further improved.

It is to be noted that the tow knob 264 is not restricted to a positionbetween the bend prevention portion 263 below the insertion openingportion 61 and the grip 262. For example, as in the first modificationof the operation portion 13 of the endoscope 1 according to the 33rdembodiment shown in FIG. 67A it may be provided to the connector-sidebend prevention portion 14 a arranged at a connection portion with theuniversal cord 14, the connector 18 or the grip 262.

Furthermore, the operating means of the guide wire fixing elevator base267 is not restricted to a knob type, and it may be a lever type usingthe operation lever 278 as in the second modification of the operationportion 13 in the endoscope 1 shown in FIG. 67B. At this moment,although the link mechanism described in the 29th embodiment is thebasis as the operation force transmission mechanism of the operationlever 278, the present invention is not restricted there to if thetowing operation is possible.

Moreover, FIGS. 66A and 66B show a 34th embodiment according to thepresent invention. In this embodiment, a guide wire fixing mechanism 361having a different structure is provided in place of the guide wirefixing elevator base 267 according to the 29th embodiment.

That is, a substantially block-like guide wire fixture 362 is providedto the guide wire fixing mechanism 361 according to the presentembodiment. In the end hard portion 21 at the end portion 17 of theinsertion portion 12 in the endoscope 1, an accommodation chamber 363 ofthe guide wire fixture 362 is provided on the upper surface of thelead-in guide path 24 communicating with the channel opening portion 26.A coil-like spring member 364 for giving impetus in the direction alongwhich the guide wire fixture 362 is pulled to the outside of theaccommodation chamber 363 in the substantially vertical direction isprovided in this accommodation chamber 363.

In addition, an end portion of the tow wire 365 is fixed to the guidewire fixture 362. The tow wire 365 is led to the operation portion 13through the tow wire channel 366 and connected to a non-illustrated linkmechanism. As a result, the towing operation of the guide wire fixture362 is enabled through the tow wire 365 by the operation of theoperation lever 72 on the front side as in the 29th embodiment.

It is to be noted that an elastic member 276 shown in FIG. 59A and aprotrusion 277 shown in FIG. 59B may be provided on the contact surfacewith the guide wire 68 in the guide wire fixture 362 as in the 29thembodiment.

The effect of this embodiment will now be described. When using theendoscope 1 according to this embodiment, the tow wire 365 is pulled bythe operation lever 72 in the initial state in advance, and the guidewire fixture 362 is drawn in to the accommodation chamber 363 as shownin FIG. 68A.

Then, as in the 29th embodiment, after the guide catheter 67 and theguide wire 68 are inserted in to the body through the channel 23, theoperation for loosening the tow wire 365 is carried out by themanipulation of the operation lever 72 with the guide catheter 67 beingpulled in to the channel 23. At this moment, the guide wire fixture 362is substantially vertically pulled to the outside of the accommodationchamber 363 by the elastic force of the spring member 364 and caused toprotrude in to the lead-in guide path 24 as shown in FIG. 68B. As aresult, the guide wire 68 is sandwiched between the end hard portion 21and the guide wire fixture 362 and mechanically fixed.

Additionally, after confirming that the guide wire 68 is fixed, theguide catheter 67 is completely pulled to the outside of the therapeuticinstrument insertion channel 23 from the operation portion 13 side ofthe endoscope 1.

Thereafter, a therapeutic instrument which is subsequently used isinserted from the base end portion side of the guide wire 68. At thismoment, with the guide wire 68 being used as a guide, the therapeuticinstrument is inserted in to the therapeutic instrument insertionchannel 23. Then, when the therapeutic instrument hustles against theguide wire fixture 362, the operation lever 72 is operated to releasefixation by the guide wire fixture 362 in order to further insert thetherapeutic instrument in to a pancreatic/hepatic duct (not shown).

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the guide wire 68 can be readily fixed by themanipulation of the operation lever 72 of the front operation portion 13in the endoscope 1, and the lead-in guide path 24 is opened byaccommodating the guide wire fixture 362 in the accommodation chamber363 in a usual case. Therefore, the therapeutic instrument can beinserted without incident.

Further, since conventional therapeutic instruments can be used in thisembodiment, the excellent operability can be maintained by use of anoperator's favorite therapeutic instrument. Furthermore, since the guidewire 68 can be fixed at the end portion 17 of the insertion portion 12in the endoscope 1, the length of the guide wire 68 can be shortened ascompared with a prior art, thereby improving the operability.

Moreover, FIGS. 69A to 69C show a 35th embodiment according to thepresent invention. In this embodiment, the structure is changed so thata torque transmission member 371 is provided between the guide wirefixture 362 according to the 34th embodiment and the tow wire 365. Thistorque transmission member 371 is provided at the upper portion in theaccommodation chamber 363 of the end hard portion 21 provided at the endportion 17.

In addition, as shown in FIG. 69C, a rotary shaft 372 is provided in thevicinity of the center of the torque transmission member 371. Further,an end portion of the tow wire 365 is fixed to one end portion of thetorque transmission member 371.

Furthermore, a slit-like opening portion 374 in to which the springmember 364 is inserted is provided on the opposite side to the fixingend 373 of the tow wire 365 in the torque transmission member 371.

Moreover, a recess portion 375 for preventing interference with thetorque transmission member 371 during rotation of the torquetransmission member 371 is formed at the end hard portion 21 by scrapingaway the lower part of the rotary shaft 372.

The effect of this embodiment will now be described. When using theendoscope 1 of this embodiment, the torque transmission member 371 ispreviously arranged so as to be substantially parallel to the lead-inguide path 24 in the initial state as shown in FIG. 69A. As a result,since the spring member 364 has a natural length, the guide wire fixture362 is accommodated in the accommodation chamber 363.

In addition, as in the 29th embodiment, after the guide catheter 67 andthe guide wire 68 are inserted in to the body through the channel 23,the operation for towing the tow wire 365 is performed by themanipulation of the operation lever 72 with the guide catheter 67 beingpulled in to the channel 23. At this moment, one end of the torquetransmission member 371 is pulled by the tow wire 365 and moves upwardsand, at the same time, the other end moves downward.

Consequently, the guide wire fixture 362 is substantially verticallypulled to the outside of the accommodation chamber 363 and caused toprotrude to the inside of the lead-in guide path 24 as shown in FIG.69B. As a result, the guide wire 68 is sandwiched between the end hardportion 21 and the guide wire fixture 362 and mechanically fixed.

Additionally, when releasing fixation of the guide wire 68, the torquetransmission member 371 returns to its original position by returningthe operation lever 72 to its original position, and the guide wirefixture 362 also returns to the accommodation chamber 36 by theresilience of the spring member 364, thereby releasing fixation of theguide wire 68.

In this embodiment, the following advantage can be demonstrated. Thatis, in this embodiment, the guide wire 68 can be readily fixed by themanipulation of the operation lever 72 of the front operation portion 13of the endoscope 1 as in the 34th embodiment, and the lead-in guide path24 is opened by accommodating the guide wire fixture 362 in theaccommodation chamber 363 in an usual case. Thus, the therapeuticinstrument can be inserted without incidence.

Also, in this embodiment, in addition to the advantage similar to thatof the 34th embodiment, since the towing state by the operation lever 72can be maintained at the time of fixing the guide wire 68, the strongforce can be applied to the guide wire fixture 362 through the torquetransmission member 371.

Further, FIGS. 70A to 70C show a 36th embodiment according to thepresent invention. In this embodiment, the guide wire fixing mechanism311 having a different structure is provided in place of the guide wirefixing elevator base 267 according to the 29th embodiment.

That is, as shown in FIG. 70A, a platy guide wire fixing member 312which can be elastically deformed is provided to the guide wire fixingmechanism 311 according to this embodiment. In the end hard portion 21at the end portion 17 of the insertion portion 12 in the endoscope 1, anaccommodation chamber 313 of the guide wire fixing member 312 isprovided on the upper surface of the lead-in guide path 24 communicatingwith the channel opening portion 26. A coil-like spring member 314 forgiving impetus in the direction along which the guide wire fixing member312 is pulled in to the accommodation chamber 313 is provided in thisaccommodation chamber 313.

The end portion of the tow wire 315 is fixed to the guide wire fixingmember 312.

Furthermore, a guide roller 316 which is rotatable below theaccommodation chamber 313 on the lower surface of the lead-in guide path24 is provide to the end hard portion 21. Moreover, the tow wire 315running out toward the lower part of the accommodation chamber 313 isled to the operation portion 13 side in the state that it is bent towardthe operation portion 13 side by the guide roller 316, and connected tothe non-illustrated link mechanism. As a result, as in the 29thembodiment, the towing operation of the guide wire fixing member 312 isenabled through the tow wire 315 by the manipulation of the operationlever 72 on the front side.

Incidentally, although the above-described link mechanism is the basisas the towing mechanism for the guide wire fixing member 312, thepresent invention is not restricted there to as long as the guide wirefixing member 312 can be towed.

The effect of this embodiment will now be described. When using theendoscope 1 according to this embodiment, as in the 29th embodiment,after the guide catheter 67 and the guide wire 68 are inserted in to thebody through the channel 23, the operation for towing the guide wirefixing member 312 is carried out through the tow wire 315 by themanipulation of the operation lever 72 with the guide catheter 67 beingpulled in to the lead-in guide path 24 or the channel 23. At thismoment, the guide wire fixing member 312 is pulled out from theaccommodation chamber 313, and the lower end portion of the guide wirefixing member 312 is brought in to contact with the lower surface of thelead-in guide path 24 of the end hard portion 12 as shown in FIG. 70C.As a result, the guide wire 68 is fixed by sandwiching the guide wire 68between the lower surface of the lead-in guide path 24 of the end hardportion 21 and the guide wire fixing member 312.

In addition, when the operation lever 72 is returned to its originalposition, the guide wire fixing member 312 is returned to the state thatit is pulled in to the accommodation chamber 313 by the resilience ofthe spring member 314. Consequently, the lower end portion of the guidewire fixing member 312 moves away from the guide wire 68, and fixationof the guide wire 68 is hence released.

In this embodiment, the guide wire fixing member 312 is subjected to thetowing operation through the tow wire 315 by the manipulation of theoperation lever 72, and the guide wire 68 can be releasably fixed at theend portion 17 of the insertion portion 12 of the endoscope 1 by theguide wire fixing member 312, thereby obtaining the advantage similar tothe 29th embodiment. In addition to the advantage of the 29thembodiment, there is an advantage that the guide wire fixing member 312does not interfere with a case when the guide wire fixing member 312 isaccommodated in the accommodation chamber 313 of the end portion 17 incase of releasing fixation of the guide wire 68 in this embodiment inparticular.

Additionally, FIGS. 71 and 72 show a 37th embodiment according to thepresent invention. In this embodiment, the structure of the end portion17 of the endoscope 1 according to the 24th embodiment is changed asfollows.

That is, in this embodiment, a wire-type guide wire fixture 81 which iscurved in to a substantially U shape is provided at the end portion ofthe tow wire 75 according to the 24th embodiment as shown in FIG. 71,and the end portion of the guide wire fixture 81 is fixed on the sidesurface of the channel opening portion 26 in the notch portion 17 a atthe end portion 17 in the endoscope 1. A method for fixing the guidewire fixture 81 to the end portion 17 is adhesion, soldering, screwingand others.

The effect of this embodiment will now be described. When using theendoscope 1 according to this embodiment, the guide wire fixture 81 ispreviously set in the extended state so as to surround the channelopening portion 26 as shown in FIG. 71.

Then, as in the 24th embodiment, after the guide wire 68 and the guidecatheter 67 are inserted in to the therapeutic instrument insertionchannel 23, the guide catheter 67 is pulled to the inside of the channel23 and only the guide wire 68 is caused to protrude to the outside ofthe channel opening portion 26 in case of fixing the guide wire 68. Inthis state, the operation for pulling the guide wire fixture 81 to thefront side is carried out by the manipulation of the operation lever 72on the front side. As a result, as shown in FIG. 72, the guide wire 68is sandwiched between the front side wall surface 26 a of the channelopening portion 26 and the guide wire fixture 81 as shown in FIG. 72,and the guide wire 68 is fixed.

In this embodiment, the guide wire 68 can be easily fixed by the guidewire fixture 81 at the end portion of the tow wire 75 by manipulatingthe operation lever 72 on the front operation portion 13 side in theendoscope 1 as in the 24th embodiment, thereby obtaining the advantagesimilar to that of the 24th embodiment.

Also, in this embodiment in particular, besides the advantage of the24th embodiment, the guide wire fixture 81 is formed by only fixing theend portion of the tow wire 75 as the operating means on the sidesurface of the channel opening portion 26 in the notch portion 17 a ofthe end portion 17 in the endoscope 1, which is inexpensive.

Further, FIG. 73 shows a modification of the tow wire 75 which is in thefixed state at the end portion of the guide wire fixture 81 in theendoscope 1 according to the 37th embodiment.

In this modification, as shown in FIG. 73, a plate material 82 is fixedto the end portion of the guide wire fixture 81 by solder and the like,and the plate material 82 is connected to the end portion 17 of theendoscope 1 by a pin 83 and the like so as to be capable of swiveling.

Furthermore, as in the 24th embodiment, a protrusion 70 by which theguide wire fixture 81 can be temporarily fixed in the extended state maybe provided to the notch portion 17 a of the end portion 17 in theendoscope 1 on the end side away from the channel opening portion 26.

Thus, in this modification, the plate material 82 is fixed to the guidewire fixture 81, and the plate material 82 is connected to the endportion 17 of the endoscope 1 by the pin 83 and the like so as to becapable of swiveling. Therefore, there is an advantage that the loadacting on the guide wire fixture 81 can be reduced when operating theguide wire fixture 81.

Moreover, FIGS. 74A to 74C show a 38th embodiment according to thepresent invention. In this embodiment, the structure of the end portion17 of the endoscope 1 according to the 24th embodiment is changed asfollows.

That is, in this embodiment, as shown in FIGS. 74A and 74B, a guide wirefixture 91 which is a member different from the tow wire 75 is connectedto the end portion of the tow wire 75 according to the 24th embodiment.

The guide wire fixing plane of this guide wire fixture 91 may have acircular shape, a planar shape or a irregular shape according to thewire diameter of the guide wire 68. In addition, the end portion of thetow wire 75 is fixed to one end portion of the guide wire fixture 91.Additionally, a guiding protrusion 92 is provide to the other endportion of the guide wire fixture 91 so as to protrude therefrom.

Further, as shown in FIG. 74C, a guide groove 93 for guiding movement ofthe guide wire fixture 91 extends on the side surface portion of theaccommodation chamber 25 of the end hard portion 21 along the axialdirection of the insertion portion 12 of the endoscope 1. The guidingprotrusion 92 of the guide wire fixture 91 is engaged with the guidegroove 93. Furthermore, in the state that the guiding protrusion 92slides along the guide groove 93 with the operation of the tow wire 75,the guide wire fixture 91 is moved along the axial direction of theinsertion portion 12 of the endoscope 1.

Moreover, a range of movement of the guide wire fixture 91 by theoperation of the tow wire 75 is set from the front side wall surface 26a of the channel opening portion 26 to the end side away from thetherapeutic instrument elevator base 27.

The effect of this embodiment will now be described. In this embodiment,before inserting the guide catheter 67, the guide wire fixture 91 is setin the state that it is thrusted to the end side of the end portion 17of the endoscope 1 in advance.

Then, as in the 24th embodiment, after the guide wire 68 ad the guidecatheter 67 are inserted in to the therapeutic instrument insertionchannel 23, the guide catheter 67 is pulled to the inside of the channel23 and only the guide wire 68 is caused to protrude to the outside ofthe channel opening portion 26 in case of fixing the guide wire 68. Inthis state, the operation for pulling the guide wire fixture 91 to thefront side is carried out through the tow wire 75 by the manipulation ofthe operation lever 72 on the front side. As a result, the guide wire 68is sandwiched between the front side wall surface 26 a of the channelopening portion 26 and the guide wire fixture 91, and the guide wire 68is fixed.

In this embodiment, the guide wire 68 can be likewise easily fixed bythe guide wire fixture 91 at the end portion of the tow wire 75 bymanipulating the operation lever 72 on the front operation portion 13side in the endoscope 1 as in the 24th embodiment, and the advantagesimilar to that of the 24th embodiment can be obtained.

Also, in this embodiment in particular, the guide groove 93 is providedon the side surface portion of the accommodation chamber 25 of the endhard portion 21, and the guiding protrusion 92 of the guide wire fixture91 is engaged with the guide groove 93. Therefore, the guide wirefixture 91 does not move out from the channel opening portion 26,thereby enabling the stable operation for fixing the guide wire 68.

Further, as in the modification of the endoscope 1 in the 38thembodiment shown in FIG. 75, the tow wire 75 of the guide wire fixture91 may be provided on the upper surface portion of the end hard portion21 as long as the tow wire 75 does not enter the observation visualfield extending from the object lens 57.

Furthermore, FIGS. 76 to 80 show a 39th embodiment. In this embodiment,the inner structure of the end portion 17 of the insertion portion 12 inthe endoscope 1 according to the 24th embodiment is changed as follows.

That is, in this embodiment, as shown in FIG. 78, a second openingportion 561 is formed at the upper surface portion of the channelopening 26 in the end hard portion 21. The base end portion of thesecond opening portion 561 is connected to the end portion of the guidewire fixture insertion channel 563 through a connection pipe 562 fixedto the channel hole of the end hard portion 21. The base end portion ofthe guide wire fixture insertion channel 563 is connected to a secondinsertion mouth ring portion 564 provided to the operation portion 13 ofthe endoscope 1 as shown in FIG. 76.

It is to be noted that the opening position of the guide wire fixationinsertion channel 563 on the front side is not restricted to theposition of the second insertion mouth ring portion 564 of the operationportion 13 shown in FIG. 76, and it may be set anywhere as long as thatposition can facilitate the fixing operation.

Moreover, the guide wire fixture 565 which performs the operation forfixing the guide wire 68 is configured to be removably inserted in tothe guide wire fixture insertion channel 563. The guide wire fixture 565is constituted by assembling three components, i.e., a snare unit 566,an elastic member 567 such as a coil spring, and an exterior unit 568shown in FIG. 80.

In the snare unit 566, an end member 570 on the front side is connectedto the base end portion of the elongated tow wire 569. The end member570 is formed by a two-stage columnar member to which a columnargripping portion 571 having a large diameter and a second columnarportion 572 having a small diameter are connected.

In addition, an engagement protrusion 573 is provided to the secondcolumnar portion 572 of the end member 570, and an elastic memberstopper 574 is provide to the step portion, respectively.

Additionally, an index 575 by which a rotation position can be confirmedis provided to one side portion of the gripping portion 571 of the endmember 570.

Further, a loop-shaped snare 576 is provided to the end portion of thetow wire 569.

It is to be noted that the end portion of the tow wire 569 is notrestricted to the snare 576 and it may have a hook shape which can hookand catch the guide wire 68.

Furthermore, a soft tube 578 for guiding the tow wire 569 of the snareunit 566 is provided to the exterior unit 568. A fixing member 579 whichis releasably engaged with the end member 570 of the snare unit 566 isprovided to the base end portion of the soft tube 578.

To the fixing member 579 are provided a mouth ring pressure member 580which can be attached to the second insertion mouth ring portion 564,and a cylindrical member 581 which protrudes on the upper surface of themouth ring pressure member 580. Moreover, an L-shaped engagement groove582 is formed at the cylindrical member 581. An engagement protrusion573 of the snare unit 566 can be engaged with the engagement groove 582.

In addition, a second s topper 583 is provided to the lower portion ofthe cylindrical member 581.

Additionally, the guide wire fixture 565 is integrally assembled byinserting the snare unit 566 in to the cylindrical member 581 of theexterior unit 568 through the elastic member 567 such as a coil spring.At this moment, the elastic member 567 is arranged between the elasticmember s topper 574 of the snare unit 566 and the second s topper 583 ofthe exterior unit 568 and set in the state that the engagementprotrusion 573 of the snare unit 566 is inserted in the engagementgroove 582 of the cylindrical member 581.

It is to be noted that the guide wire fixture 565 according to thisembodiment may be substituted by a snare or a gripping therapeuticinstrument which is usually used as a therapeutic instrument.

The effect of this embodiment will now be described. Usually, as shownin FIG. 79B, the impetus in the direction along which the engagementprotrusion 573 of the snare unit 566 hustles against the end portion ofthe engagement groove 582 on the opening end side (start end portion 582a) acts on the guide wire fixture 565 according to this embodiment bythe elastic force of the elastic member 567, and the position of thesnare unit 566 is restricted in this state. In such a state, thegripping portion 571 of the snare unit 566 is caused to protrude to theouter side of the cylindrical member 581 of the exterior unit 568 andheld in this state, and the snare 576 is held in the closed state.

Further, when opening the snare 576, the gripping portion 571 of thesnare unit 566 is operated to be pushed to the inner side of thecylindrical member 581 of the exterior unit 568 against the elasticforce of the elastic member 567. With this operation, the engagementprotrusion 573 of the snare unit 566 slides in the axial direction alongthe engagement groove 582 and moves to the position at which it isbrought in to contact with the end portion of the engagement groove 582on the mouth ring pressure member 580 side. In this state, the snare 576protrudes from the soft tube 578 as shown in FIG. 79A, and the snare 576is opened.

Subsequently, the gripping portion 571 is swiveled in thecounterclockwise direction at this position, and the engagementprotrusion 573 is brought in to contact with the engagement end portion582 b at the dead end of the engagement groove 582 as shown in FIG. 79A.As a result, the engagement protrusion 573 can be engaged, and the snare576 can be held in the opened state.

Furthermore, when closing the snare 576, the engagement protrusion 573comes off the engagement end portion 582 b at the dead end of theengagement groove 582 by rotating the gripping portion 571 in theclockwise direction, and the snare unit 566 returns to its originalposition shown in FIG. 79B by the elastic force of the elastic member567.

Description will now be given as to the method for fixing the guide wire68 to the end portion 17 of the insertion portion 12 by using the guidewire fixture 566 according to this embodiment. The endoscope 1 is firstinserted in to the body. Then, when a papilla is captured by the endportion 17 of the insertion portion 12, the guide wire fixture 565 isinserted from the second insertion mouth ring portion 564 with the snare576 being closed. Thereafter, when the end of the guide wire fixture 565protrudes from the second opening portion 561, the snare 576 is causedto protrude as shown in FIG. 77B by pushing the gripping portion 571.The subsequent operation is similar to that of the guide wire fixture 69according to the 24th embodiment.

The following advantage can be demonstrated in this embodiment. That is,the advantage similar to that of the 24th embodiment can be obtained inthis embodiment. In addition to this, since the guide wire fixture 565can be easily removed from the endoscope 1, the end portion 17, theinside of the guide wire fixture insertion channel 563 and the guidewire fixture 565 can be readily cleaned/sterilized.

Moreover, there is an advantage that the inner structure of the endportion 17 of the insertion portion 12 in the endoscope 1 can besimplified.

In addition, the existing snare, the therapeutic instrument for grippingand others can substitute the guide wire fixture 565. Also, when theguide wire fixture 565 is not used, the guide wire fixture insertionchannel 563 can be used as the treatment channel or the front watersupply duct.

A 40th embodiment according to the present invention will now bedescribed with reference to FIGS. 81 to 85. FIG. 81 shows a schematicstructure in an end portion 603 of an insertion portion 602 of anendoscope 601 in an endoscope apparatus according to this embodiment. Inthe endoscope apparatus according to this embodiment, there is used aside viewing type endoscope 601 for observing a direction substantiallyorthogonal to the axial direction of the insertion portion 602.

To the side viewing type endoscope 601 is formed a substantially planarside viewing reference plane 612 which is formed by notching the outerperipheral surface of the end portion 603 of the insertion portion 602.An illumination window 613 of an illumination optical system and anobservation window 614 of an observation optical system are aligned onthe side viewing reference plane 612 in the front-and-back direction.Additionally, a channel opening portion 615 is provided next thealignment portion of the illumination window 613 and the observationwindow 614 on the side viewing reference plane 612. This channel openingportion 615 constitutes the end opening portion of the therapeuticinstrument insertion channel 616 provided in the insertion portion 602of the endoscope 601.

Further, a therapeutic instrument elevator base 617 is provided to thechannel opening portion 615. As shown in FIG. 85, one end portion of thetherapeutic instrument elevator base 617 is connected to a main body 611a of the end portion 603 through a swiveling shaft 618 so as to becapable of swiveling without restraint.

Furthermore, one end portion of a non-illustrated flexible operationwire is fixed to the other end portion of the therapeutic instrumentelevator base 617. The other end portion of the operation wire isextended to an operation portion 606 side. Moreover, the operation wireis towed in cooperation with manipulation of a non-illustratedtherapeutic instrument elevator base operation lever provided to theoperation portion 606, and the operation of this operation wire drivesthe therapeutic instrument elevator base 617 to swivel around theswiveling shat 618. At this moment, the therapeutic instrument elevatorbase 617 is caused to swivel from a standby position (set-down position)indicated by dotted lines in FIG. 85 to a maximum swivel position(set-up position) indicated by solid lines in FIG. 85, and each of theelevator operation and the set-down operation in a therapeuticinstrument 619, for example, an contrasting tube shown in FIGS. 83A and83B, which is extended from the channel opening portion 615 to theoutside is carried out in the visual field of the observation window 614by the swiveling operation of the therapeutic instrument elevator base617.

Moreover, as the therapeutic instrument 619 inserted in to thetherapeutic instrument insertion channel 616 of the endoscope 601according to this embodiment, a therapeutic instrument such as anexisting contrasting tube provided with a guide wire lumen in to which alater-described guide wire 630 can be inserted can be used as it is.

Incidentally, the therapeutic instrument 619 which has a structure forreducing the frictional force with respect to the guide wire 630 or hasthe smoothed inner surface of the guide wire lumen by applying coatingto the guide wire lumen is further preferable in this embodiment.

In addition, a substantially-V-shaped receiving groove portion 20 isformed on the opposite surface to the therapeutic instrument 619 in thetherapeutic instrument elevator base 617. Additionally, when raising thetherapeutic instrument 619, the therapeutic instrument 619 is brought into contact with the therapeutic instrument elevator base 617 with thetherapeutic instrument 619 being inserted in the receiving grooveportion 20 to be positioned, and the therapeutic instrument 619 isguided in the vertical direction.

Further, in the side viewing type endoscope 601 according to thisembodiment, a guide wire fixing member 621 as guide wire fixing means isattached in the vicinity of the end portion 603 of the insertion portion602. To the guide wire fixing member 621 are provided a substantiallycylindrical soft attachment portion 622 which is formed of a materialsuch as chloroethene and a substantially cylindrical cap portion 623connected to the end side of the attachment portion 622.

Furthermore, a material of the attachment portion 622 does not have tobe necessarily chloroethene, and it may be polyethylene, polystyrene orpolyurethane as long as it is a soft resin. Moreover, with the capportion 623 being arranged around the end portion 603 of the insertionportion 602, the attachment portion 622 is attached in the vicinity ofthe end portion 603 of the insertion portion 602 in the endoscope 601.As a result, the guide wire fixing member 621 is detachably attached onthe channel opening portion 615 or the insertion portion 602 on the baseend side away from the channel opening portion 615 in the vicinity ofthe end portion 603 of the insertion portion 602 in the endoscope 601.

In addition, the cap portion 623 is made of polycarbonate resin havingthe transparency. As to a color tone of the cap portion 623, one havingthe high transparency is preferable, but it does not have to benecessarily transparent.

Incidentally, in regard to a composition of a material of the capportion 623, polycarbonate resin is most preferable, but acrylic resin,polyethylene resin, polypropylene resin, polystyrene resin and otherscan be also used.

Further, on the end side of the cap portion 623 is formed a therapeuticinstrument insertion opening window 624 at a position corresponding tothe illumination window 613, the observation window 614 and the channelopening portion 615 on the side viewing reference plane of the endportion 603. The therapeutic instrument insertion opening window 624 ofthe cap portion 623 is opened on the reference plane 612 side of theinsertion portion 602 of the endoscope 601. The opening window 624 isformed in to a substantially rectangular shape in such a manner that awidth thereof is approximately ¼ of the circumference of the cap portion623 whilst a length thereof is approximately 10 mm. As a result, thevisual field of the observation window 614 of the endoscope 601 or theforward/backward movement of the therapeutic instrument 619 such as acontrasting tube extended to the outer side from the channel openingportion 615 can not be obstructed, and later-described guide wireidentification members 627 a and 627 b can be easily actuated. Also, alater-described guide wire fixture insertion hole 628 can be arranged atan effective position.

Furthermore, a guide wire identification mechanism portion 625 and aguide wire fixing mechanism 626 are provided to the therapeuticinstrument insertion opening window 624 of the cap portion 623. To theguide wire identification mechanism portion 625 are provided guide wireidentification members 627 a and 627 b which consist of two stainlesssteel wires projecting to the inner side of the opening window 624 fromthe both sides of the opening window 624.

Moreover, one of the two guide wire identification members 627 a and 627b, i.e., the first guide wire identification member 627 a is extendedfrom the left side of the therapeutic instrument insertion openingwindow 624 to the inner side along the upper edge portion of the capportion 623 and curved downward in FIG. 82. In addition the other secondguide wire identification member 627 b is extended from the right sideof the therapeutic instrument insertion opening window 624 to the innerside along the upper edge portion of the cap portion 623 and curveddownward in FIG. 82. Respective lower extended portions 627 a 1 and 627b 1 of the two guide wire identification members 627 a and 627 b arespaced from each other and oppositely arranged substantially in parallelalong the direction of the center line of the guide wire fixing member621. A space S having an appropriate width dimension L is formed betweenthe respective lower extended portions 627 a 1 and 627 b 1 of the guidewire identification members 627 a and 627 b. This space S is set so asto be larger than, e.g., the outside diameter dimension of the guidewire 630.

Additionally, guide wire fixture insertion holes 628 are respectivelyformed to the both side portions of the therapeutic instrument insertionopening window 624 in the cap portion 623. These guide wire fixtureinsertion holes 628 are arranged at a substantially central position ofthe therapeutic instrument insertion opening window 624 along thedirection of the center line of the guide wire fixing member 621.

Further, to the guide wire fixing mechanism portion 626 is provided aguide wire fixture 629 formed of a filate member having no elasticproperty, e.g., a surgical suture having an outside diameter dimensionof approximately 0.2 mm. One end portion of the guide wire fixture 629is fixed to the first guide wire identification member 627 a on the leftside in FIG. 82. Furthermore, the guide wire fixture 629 passes throughthe guide wire fixture insertion hole 628 of the therapeutic instrumentinsertion opening window 624 on the left side (first guide wireidentification member 627 a side) in FIG. 82, then cuts across theopening window 624, and passes through the guide wire fixture insertionhole 628 on the right side (second guide wire identification member 627b side) in FIG. 82 so that the other end portion side of the guide wirefixture 629 is fixed to the second guide wire identification member 627b. As a result, the guide wire fixture 629 is attached so as to bespanned between the both side portions on the opening window 624.

Incidentally, although the surgical suture having an outside diameterdimension of approximately 0.2 mm is used as the guide wire fixture 629in this embodiment, any other thread made of a resin such as nylon maybe used as long as it is a pliable filate member which has no elasticproperty but the high tensile strength.

Moreover, the guide wire identification members 627 a and 627 b are notrestricted to stainless steel wires, and a copper wire, any othermetallic wire made of, e.g., superelastic alloy manufactured by NiTi ora resin wire may be used as long as it is an elastic member.

Consequently, when the therapeutic instrument 619 is being drawn fromthe channel opening portion 615 on the end portion 603 side of theinsertion portion 602 in the endoscope 601, the guide wire fixingmechanism portion 626 does not obstruct the operation of the therapeuticinstrument 619. Also, when only the guide wire 630 is being drawn fromthe channel opening portion 615, the guide wire 630 is welded withpressure to and engaged with the guide wire fixture 629 between the bothside portions on the opening window 624 of the guide wire fixing member621 by the thrusting force from the therapeutic instrument elevator base617.

When the therapeutic instrument 619 is being pulled to the operationportion front side by the guide wire fixing mechanism portion 626 afterbeing inserted in to the therapeutic instrument insertion channel 616, aprotruding length of the therapeutic instrument 619 which is requiredfor the operation is assured from the channel opening portion 615 as theoperation portion front side opening of the therapeutic instrumentinsertion channel 616.

In addition, when the guide wire 630 is inserted in to the guide wirelumen of the therapeutic instrument 619, a necessary protruding lengthof the guide wire 630 is provided from the end of the therapeuticinstrument 619 in accordance with a target portion, and a protrudinglength of the same which is required for the operation is assured fromthe rear end of the therapeutic instrument 619.

The protruding length from the end of the therapeutic instrument 619 isapproximately not more than 40 cm, and an protrusion amount ofapproximately 10 cm from the mouth ring 604 a provided on the base endside of the therapeutic instrument 619 can obtain the most excellentoperability and is ideal.

The effect of this embodiment will now be described. When using theendoscope apparatus according to this embodiment, if the therapeuticinstrument 619 such as a contrasting tube is inserted in to thetherapeutic instrument insertion channel 616 on the operation portion606 side of the endoscope 601 and used, the end portion of thetherapeutic instrument 619 is caused to protrude from the channelopening portion 615 of the end portion 603 of the insertion portion 602in the endoscope 601. At this moment, if the therapeutic instrumentelevator base 617 is held at a standby position (set-down position)indicated by dotted lines in FIG. 85, the end portion of the therapeuticinstrument 619 is moved away from the guide wire identification members627 a and 627 b of the guide wire identification mechanism portion 625and held at a freely movable position as shown in FIG. 83A.

In this state, by manipulating a non-illustrated therapeutic instrumentelevator base operation lever of the operation portion 606 of theendoscope 601, the therapeutic instrument elevator base 617 at the endportion 603 of the insertion portion 602 is operated to be raised. Then,the end portion of the therapeutic instrument 619 is pushed out in thedirection along which it is inserted in to the therapeutic instrumentinsertion opening window 624 of the cap portion 623 by the therapeuticinstrument elevator base 617 with this operation.

At this moment, the therapeutic instrument 619 is inserted between therespective lower extended portions 627 a 1 and 627 b 1 of the two guidewire identification members 627 a and 627 b projecting from the bothsides of the therapeutic instrument insertion opening window 624 of thecap portion 623. Therefore, the space between the respective lowerextended portions 627 a 1 and 627 b 1 of the two guide wireidentification members 627 a and 627 b is extended by the therapeuticinstrument 619, and the gap between the respective lower extendedportions 627 a 1 and 627 b 1 is widened. Consequently, when therespective guide wire identification members 627 a and 627 b move closeto the guide wire fixture insertion holes 628 on the both sides of thetherapeutic instrument insertion opening window 624, the tensile forceof the guide wire fixtures 629 respectively fixed to the respectiveguide wire identification members 627 a and 627 b is relaxed. As aresult of relaxing the tensile force of the guide wire fixture 629 inthis manner, when the end portion of the therapeutic instrument 619 ispushed out in the direction along which it is inserted in to thetherapeutic instrument insertion opening window 624 of the cap portion623 by the therapeutic instrument elevator base 617, the therapeuticinstrument 619 is not engaged by the guide wire fixture 629, and theoperation for raising the therapeutic instrument 619 is carried out asusual.

Additionally, if the therapeutic instrument elevator base 617 is held atthe standby position (set-down position) indicated by dotted lines inFIG. 85 when the end portion of the guide wire 630 is led out from thechannel opening portion 615 of the endoscope 601, the guide wire 630moves away from the guide wire fixture 629 as shown in FIG. 84A and isheld at a freely movable engagement releasing position.

When the therapeutic instrument elevator base 617 is swiveled to amaximum swiveling position (set-up position) indicated by solid lines inFIG. 85 in this state, the guide wire 630 is pushed out in the directionalong which it is inserted between the guide wire identification members627 a and 627 b of the guide wire identification mechanism portion 625by the therapeutic instrument elevator base 617 as shown in FIG. 84B. Atthis moment, since the space S between the respective lower extendedportions 627 a 1 and 27 b 1 of the guide wire identification members 627a and 627 b is larger than, e.g., the outside diameter dimension of theguide wire 630, the space S between the two lower extended portions 627a 1 and 627 b 1 is not widened by the guide wire 630 inserted betweenthe respective lower extended portions 627 a 1 and 627 b 1 of the guidewire identification members 627 a and 627 b, and the tensile force ofthe guide wire fixture 629 spanned between the both side portions overthe opening window 624 of the guide wire fixing member 621 is notrelaxed.

In this case, with the operation by which the therapeutic instrumentelevator base 617 of the end portion 603 of the insertion portion 602 israised by manipulation of the non-illustrated therapeutic instrumentelevator base operation lever, the guide wire 630 is welded withpressure to the guide wire fixture 629 between the both side portionsover the opening window 624 in the guide wire fixing member 621 by thethrusting force from the therapeutic instrument elevator base 617. Atthis moment, since the guide wire 630 receives the force in the oppositedirections between the therapeutic instrument elevator base 617 and theguide wire fixture 629 alternately in the shearing manner, the guidewire 630 is releasably engaged.

Further, when using the endoscope apparatus according to thisembodiment, after the therapeutic instrument 619 such as a contrastingtube is inserted in to a pancreatic/hepatic duct (not shown) in thepapillotomy manner, the operation for replacing the therapeuticinstrument 619 is carried out as follows. The guide wire 630 is firstinserted from the mouth ring 4 b provided on the base end side of thetherapeutic instrument 619 and led to the pancreatic/hepatic duct (notshown).

Insertion of the guide wire 630 in to the pancreatic/hepatic duct (notshown) is confirmed, and the therapeutic instrument 619 is pulled outwhile gripping the base end side of the guide wire 630 by a hand so asto avoid movement of the guide wire 630. At this moment, afterconfirming that the end portion of the therapeutic instrument 619 hasbeen pulled out of a papilla (not shown) by an endoscopic image, thetherapeutic instrument 619 is further pulled out.

Subsequently, when the end of the therapeutic instrument 619 isaccommodated in the channel opening portion 615 on the end portion 603side of the insertion portion 602, the guide wire 630 is similarlyraised along the therapeutic instrument elevator base 617 by raising thetherapeutic instrument base 617, and the guide wire 630 is mechanicallyfixed in the vicinity of the end portion 603 of the insertion portion602 of the endoscope 601 by the guide wire fixing mechanism portion 626.

Furthermore, after confirming that the guide wire 630 is fixed, thetherapeutic instrument 619 is completely pulled out from the operationportion 606 side of the endoscope 601. Thereafter, a therapeuticinstrument 619 which is subsequently used is inserted from the base endside of the guide wire 630 and caused to hustle against the therapeuticinstrument elevator base 617. Then, the therapeutic instrument elevatorbase 617 is lowered, and only the therapeutic instrument 619 is insertedin to the pancreatic/hepatic duct (not shown) with the guide wire 630being used as a guide while gripping the base end portion of the guidewire 630.

Therefore, an operator does not have to keep gripping the guide wire 630when replacing the therapeutic instrument 619. Moreover, the therapeuticinstrument can be thereafter replaced for a necessary number of times bythe similar method.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the therapeutic instrument 619 other than the guidewire 630 can be raised or moved forward/backward by operating thetherapeutic instrument elevator base 617 as in the prior art, and onlythe guide wire 630 is sandwiched between the therapeutic instrumentelevator base 617 and the guide wire fixture 629 by the operation of thetherapeutic instrument elevator base 617 and fixed in the engaged state.Therefore, in the operation for replacing the therapeutic instrument619, it is no longer necessary to grip the guide wire 630 on theoperation portion 606 side of the endoscope 601 as in the prior art byengaging only the guide wire 630 between the therapeutic instrumentelevator base 617 and the guide wire fixture 629 by the operation of thetherapeutic instrument elevator base 617. Accordingly, since there is anadvantage that the operation for replacing the therapeutic instrument619 can be facilitated, the operation time required for replacing thetherapeutic instrument 619 can be shortened.

In addition, when inserting the guide wire 630 in to the therapeuticinstrument 619, for example, 4 m of the guide wire 630 must be insertedin the prior art, but insertion of, e.g., approximately 2.5 m of theguide wire 630 can suffice in the present invention. Thus, the entirelength of the guide wire is approximately 4 m in the prior art, and morethan a half of the guide wire 630 is projecting from the endoscope 601even when it is being inserted in the endoscope 601. Therefore, thepossibility that the guide wire 630 may be brought in to contact with anunclean area such as a floor during handling is high, and caution isneeded. In the present invention, however, a length of the part of theguide wire 630 which is projecting from the endoscope 601 is short, andthe possibility that the guide wire 630 may be brought in to contactwith the unclean area is low, thereby facilitating handling.

Further, when only the therapeutic instrument 619 is removed with theguide wire 630 remaining at a papilla, the two operations, i.e., thetherapeutic instrument 619 is pulled out whilst the guide wire 630 ispushed in by an amount according to a removed amount of the therapeuticinstrument 619, must be carried out at the same time in the prior art.In the present invention, however, the guide wire 630 does not have tobe gripped on the operation portion 606 side, and one operation, namely,directly pulling out only the therapeutic instrument 619 can suffice.Thus, it is possible to reduce the time required for replacing thetherapeutic instrument and a number of assistants and simplify thetechnique.

Furthermore, FIGS. 86A, 86B to 89A and 89B show a 41st embodimentaccording to the present invention. In this embodiment, a guide wirefixing member 641 which is different from the guide wire fixing member621 according to the 40th embodiment and has a structure shown in FIGS.86A and 86B is attached to the end portion 603 of the insertion portion602 in the endoscope 601 according to the 40th embodiment.

That is, to the guide wire fixing member 641 according to thisembodiment are provided a substantially-funnel-like attachment portion642 and a substantially cylindrical cap portion 643 connected to the endside of the attachment portion 642.

Moreover, as shown in FIG. 87A, to the attachment portion 642 isprovided a tapered attachment portion main body 644 which has asubstantially cylindrical shape and whose outside diameter dimensionbecomes large in such a manner that its wall thickness graduallyincreases toward the base end portion side (lower side in FIG. 87A) ofthe insertion portion 602 of the endoscope 601. A plurality of, forexample, four slits 645 are formed to a cylindrical wall portion of theattachment portion main body 644 in this embodiment as shown in FIG.86B. These slits 645 are opened on the base end portion side of theattachment portion main body 644. In addition, four elasticallydeformable tongue pieces 646 are formed by parts between the respectiveslits 645.

Additionally, to the outer side of the guide wire fixing member 641 isprovided a fixing ring 647 which releasably fixes the attachment portion642 of the guide wire fixing member 641 to the end portion 603 of theinsertion portion 602 in the endoscope 601. The inside diameterdimension of the fixing ring 647 is set in such a manner that it islarger than a minimum outside diameter portion 646 at which the outsidediameter dimension of the tongue piece 646 of the attachment portionmain body 644 is minimum in the guide wire fixing member 641 and it issmaller than a maximum outside diameter portion 646 b at which theoutside diameter dimension of the tongue piece 646 of the attachmentportion main body 644 is maximum in the guide wire fixing member 641.

Further, as shown in FIG. 87A, in the state that the fixing ring 647 isheld at the engagement releasing position at which the fixing ring 647is not engaged with the tongue pieces 646 of the attachment portion mainbody 644, the guide wire fixing member 641 is held so as to be movablewith respect to the insertion portion 602 of the endoscope 601.

Furthermore, when the fixing ring 647 is moved in the direction of theengagement position at which the fixing ring 647 is engaged with thetongue pieces 646 of the attachment portion main body 644, the tonguepieces 646 of the attachment portion main body 644 is inwardly pushed bythe fixing ring 647 so that the inner end portion side of each of thefour tongue pieces 646 is inwardly elastically deformed.

Incidentally, in this embodiment, taking the dimensions of the endportion 603 of the insertion portion 602 in the endoscope 601 in toconsideration, the inside diameter dimension of the attachment portion642 of the guide wire fixing member 641 is set to, e.g., 14 mm, thelength of the same is set to 10 mm, and the tapered plane of the tonguepiece 646 of the attachment portion main body 646 is set to a taperangle of 5°. Moreover, the four slits 645 of the attachment portion mainbody 644 are equally arranged on the circumference of the attachmentportion 642 at intervals of substantially 90°.

In addition, the length of each slit 645 is parallel to the axialdirection of the endoscope 601 from the base end side of the attachmentportion 642 to the end side and set to approximately 9 mm. Additionally,as to a number of the slits 645 of the attachment portion main body 644,two to six is preferable when moldability or facilitation of attachmentto the endoscope 601 is taken in to consideration.

Further, the inside diameter dimension of the fixing ring 647 movablyattached to the attachment portion 642 is set to 16 mm, the outsidediameter dimension of the same is set to 18 mm and the width of the sameis set to approximately 2 mm, for example.

Incidentally, the fixing ring 647 is not restricted to theabove-described dimensions, and any dimensions can be adopted as long asthe fixing ring 647 has a function for fastening the slits 645 of theattachment portion 642. Therefore, as to the shape of the fixing ring647, a belt-like member or a filate member may be used.

Furthermore, as to the materials of the attachment portion 642 and thefixing ring 647, it is preferable that these members are integrallymanufactured by polycarbonate which is the same as the material of thecap portion 643 in terms of the cost. However, any other hard resin suchas acrylic, crude rubber, synthetic rubber, soft resin such as siliconor urethane, or a metal such as stainless steel may be also used. Theydo not have to be transparent in particular as long as they have theelasticity to some measure and the smooth inner surface so that the endportion 603 of the insertion portion 602 of the endoscope 601 can not bedamaged.

Moreover, as in the guide wire fixing member 621 according to the 40thembodiment, as shown in FIG. 86A, an opening window 648 is formed on theend side of the cap portion 643 of the guide wire fixing member 641.With the end portion 603 side of the insertion portion 602 of theendoscope 601 being opened, the opening window 648 is formed at a partcorresponding to the illumination window 613, the observation window 614and the channel opening portion 615 in the side viewing reference plane612 of the end portion 603 of the endoscope 601.

In addition, a guide wire identification mechanism portion 649 and aguide wire fixing mechanism portion 650 are provided to the openingwindow 648 of the cap portion 643. To the guide wire identificationmechanism portion 649 is provided a guide wire identification member 651consisting of one stainless steel wire which is projecting with respectto the opening window 648 from one side end portion of the openingwindow 648 (opposite side to the observation window 614 in the endoscope601) toward the inner side of the opening window 648. In FIG. 86A, thisguide wire identification member 651 is extended from the right side ofthe opening window 648 to the inner side along the upper edge portion ofthe cap portion 643 and curves downward.

Additionally, guide wire fixing member insertion holes 652 arerespectively formed to the cap portion 643 on the both side portions ofthe opening window 648. These guide wire fixing member insertion holes652 are arranged at substantially central positions of the openingwindow 648 along the central line direction of the guide wire fixingmember 641.

Further, to the guide wire fixing mechanism portion 650 is provided aguide wire fixture formed by a dilate member which is made up of, e.g.,a surgical suture and as no elastic property. One end portion of theguide wire fixture 653 cuts across the opening window 648, and passesthrough the guide wire fixing member insertion hole 652 on the rightside of the opening window 648 in FIG. 86A. Also, the other end portionside of the guide wire fixture 653 is fixed to the guide wireidentification member 651. As a result, the guide wire fixture 653 isattached so as to be spanned between the both side portions on theopening window 648.

The effect of this embodiment will now be described. In the firstinstance, the following operation is carried out when the guide wirefixing member 641 is attached to the insertion portion 602 of theendoscope 601 of the endoscope apparatus according to this embodiment.As shown in FIG. 87A, in the engagement releasing state that the fixingring 647 has been moved to the end portion side of the guide wire fixingmember 641, the end portion 603 of the insertion portion 602 in theendoscope 601 is first inserted into the attachment portion 642 of theguide wire fixing member 641 from the slit 645 side of the guide wirefixing member 641.

Moreover, after inserting the end portion 603 of the insertion portion602 in the endoscope 601 into the attachment portion 642, with theopening window 648 on the cap portion 643 being matched with theposition of the channel opening portion 615 of the endoscope 601, thefixing ring 647 is again moved to the base end portion side of the guidewire fixing member 641. At this moment, with the operation for movingthe fixing ring 647 to the base end portion side, the tongue piece 646between the respective slits 645 of the attachment portion 642 isthrusted to the inner side in the radial direction as shown in FIG. 87B.Therefore, at this moment, the inner end portion side of each of thefour tongue pieces 646 which are elastically deformed inwardly isengaged so as to be strongly welded to the outer peripheral surface ofthe insertion portion 602 of the endoscope 601 with pressure, and theguide wire fixing member 641 is immovably fixed to the insertion portion602 of the endoscope 601.

In addition, when using the endoscope apparatus according to thisembodiment, if the therapeutic instrument 619 such as a contrasting tubeis inserted into the therapeutic instrument insertion channel 616 on theoperation portion 606 side of the endoscope 601 and used, the endportion of the therapeutic instrument 619 is caused to protrude from thechannel opening portion 615 of the end portion 603 of the insertionportion 602 in the endoscope 601. At this moment, in cases where thetherapeutic instrument elevator base 617 is held at the standby position(set-down position) indicated by dotted lines in FIG. 85, the endportion of the therapeutic instrument 619 moves away from the guide wireidentification member 651 of the guide wire identification mechanismportion 649 and is held at a position enabling free movement as shown inFIG. 88A.

In this state, by manipulating a non-illustrated therapeutic instrumentelevator base operation lever of the operation portion 606 of theendoscope 601, the therapeutic instrument elevator base 617 of the endportion 603 of the insertion portion 602 is operated to be raised. Then,with this operation, the end portion of the therapeutic instrument 619is thrusted by the therapeutic instrument elevator base 617 in thedirection along which it is inserted into the opening window 648 of thecap portion 643.

A lower extended portion 651 a of the guide wire identification member651 in the opening window 648 of the cap portion 643 is thrusted in thetransverse direction by the moving operation of the therapeuticinstrument 619 at this moment. Additionally, the tensile force of theguide wire fixture 653 fixed to the guide wire identification member 651is relaxed by the moving operation of the guide wire identificationmember 651. When the tensile force of the guide wire fixture 653 isrelaxed in this manner, the therapeutic instrument 619 does notinterfere with the guide wire fixture 653 even though the end portion ofthe therapeutic instrument 619 is thrusted by the therapeutic instrumentelevator base 617 in the direction along which it is inserted into theopening window 648 of the cap portion 643, and the operation for raisingthe therapeutic instrument 619 is carried out as usual.

Further, with the end portion of the guide wire 630 being led out fromthe channel opening portion 615 of the endoscope 601, when thenon-illustrated therapeutic instrument elevator base operation lever ofthe operation portion 606 of the endoscope 601 is operated and thetherapeutic instrument elevator base 617 at the end portion 603 of theinsertion portion 602 is operated to be raised, the guide wire 630 isthrusted by the therapeutic instrument elevator base 617 in thedirection along which it is inserted into the opening window 648 asshown in FIG. 89B. At this moment, the lower extended portion 651 a ofthe guide wire identification member 651 is not thrusted by the guidewire 630 in the transverse direction, and the tensile force of the guidewire fixture 653 spanned between the both side portions over the openingwindow 648 of the guide wire fixing member 641 is not relaxed. Thus, inthis case, with the operation for raising the therapeutic instrumentelevator base 617 at the end portion 603 of the insertion portion 602 bymanipulating the non-illustrated therapeutic instrument elevator baseoperation lever, the guide wire 630 is welded with pressure to the guidewire fixture 653 between the both side portions over the opening window648 of the guide wire fixing member 641 by the thrusting force from thetherapeutic instrument elevator base 617. At this moment, since theguide wire 630 receives the force in the opposed directions alternatelyin the shearing manner between the therapeutic instrument elevator base617 and the guide wire fixture 653, it is releasably engaged.

As a result, the guide wire fixing mechanism portion 650 does notprevent the operation of the therapeutic instrument 619 when thetherapeutic instrument 619 is projecting from the channel openingportion 615 on the end portion 603 side of the insertion portion 602.Also, when only the guide wire 630 is projecting from the channelopening portion 615, the guide wire 630 is welded with pressure to andengaged with the guide wire fixture 653 between the both side portionsover the opening window 648 of the guide wire fixing member 641 by thethrusting force from the therapeutic instrument elevator base 617.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the therapeutic instrument 619 other than the guidewire 630 can be operated to be raised or moved forward/backward by theoperation of the therapeutic instrument elevator base 617 as in theprior art, and only the guide wire 630 is sandwiched and engaged betweenthe therapeutic instrument elevator base 617 and the guide wire fixture653 by the operation of the therapeutic instrument elevator base 617.Therefore, in the operation for replacing the therapeutic instrument619, it is no longer necessary to grip the guide wire 630 on theoperation portion 606 side of the endoscope 601 as in the prior art byengaging only the guide wire 630 between the therapeutic instrumentelevator base 617 and the guide wire fixture 653 by the operation of thetherapeutic instrument elevator base 617. Accordingly, in thisembodiment, the operation for replacing the therapeutic instrument 619can be facilitated as in the 40th embodiment, thereby shortening theoperation time required for the operation for replacing the therapeuticinstrument 619.

Also, in addition to the advantage similar to that of the 40thembodiment, the tensile force of the guide wire fixture 653 can beadjusted by one guide wire identification member 651 in this embodimentin particular. Thus, of the two guide wire identification members 627 aand 627 b used in the 40th embodiment, the guide wire identificationmember 627 a on the observation window 614 side of the endoscope 601 canbe omitted. Therefore, there is an advantage that the visual field ofthe observation window 614 of the endoscope 601 can be assured.

Furthermore, since the principle of the fixing portion for fixing theguide wire fixing member 641 to the end portion 603 of the insertionportion 602 in the endoscope 601 is based on the mechanicalengaging/releasing operation of the fixing ring 647 which does notutilize the resilience of rubber, it is advantageously possible to copewith a plurality of kinds of endoscopes 601 having different thicknessesat the attachment portion 642 in the guide wire fixing member 641 in onesize.

Moreover, since a rubber component of the insertion portion 602 in theendoscope 601 is not scraped when the guide wire fixing member 641 isattached, there is an advantage that the insertion portion 602 in theendoscope 601 is hard to be damaged and the operation for attaching theguide wire fixing member 641 can be further facilitated.

In addition, FIGS. 90 through 102A to 102D show a 42nd embodimentaccording to the present invention. In this embodiment, a guide wirefixing member 661 having a structure shown in FIG. 91 which is differentfrom the guide wire fixing member 621 according to the 40th embodimentis attached to the end portion 603 of the insertion portion 602 of theside viewing type endoscope 601 in the endoscope apparatus according tothe 40th embodiment.

That is, to the guide wire fixing member 661 according to thisembodiment are provided a guide wire fixing member main body 662 and anattachment member 663 for attaching the guide wire fixing member mainbody 662 to the endoscope 601 side.

The guide wire fixing member main body 662 will be first described. Tothe guide wire fixing member main body 662 are provided a base member664 shown in FIGS. 94A to 94C, a guide wire fixture 665 shown in FIG.95A, a guide wire identification member 666 shown in FIGS. 95B and 95C,and a top cover 667 shown in FIG. 96. Additionally, the guide wirefixture 665 and the guide wire identification member 666 are supportedso as to protrude/retreat with respect to the base member 664.

Further, a guide groove 668 for guiding the protruding/retreatingoperation of the guide wire fixture 665 and the guide wireidentification member 666 is provided on the front surface side of thebase member 664. Furthermore, as shown in FIGS. 99A and 99B, a movementrestriction portion 669 for restricting movement of the guide wirefixture 665 and the guide wire identification member 666 at a protrudingposition that the guide wire fixture 665 and the guide wireidentification member 666 are caused to protrude to the outer side ofthe base member 664 along the guide groove 668 is provided to the basemember 664 on the end portion side of the guide groove 668.

Moreover, a click groove 672 for guiding a click pin 671 of alater-described click mechanism 670 which temporarily fixes the guidewire identification member 666 is provided on the base end portion sideof the guide groove 668 of the base member 664. In addition, on the endportion side of the base member 664, stopper insertion holes 673 whichpierce from the back surface side to the front surface side arerespectively formed on the both sides of the guide groove 668 at a partin the vicinity of the movement restriction portion 669 of the guidegroove 668.

It is to be noted that an engagement groove 674 for engagement with theattachment member 663 and a stopper fixing groove 76 for fixing alater-described stopper member 675 are provided on the back surface sideof the base member 664 as shown in FIG. 94B.

In addition, the guide wire fixture 665 is a substantially tabularmember having a longitudinal dimension of approximately 10 mm, atransverse dimension of approximately 4 mm and a thickness ofapproximately 0.2 mm, and a material thereof is stainless steel.

Incidentally, the guide wire fixture 665 has an enough board thickness,and its material is not restricted to stainless steel as long as it canmaintain the rigidity. Any other metal material such as aluminium orhard resin such as acrylic, polycarbonate or ABS resin may be used.

As shown in FIG. 95A, a concave impingement portion 677 which engageswith the guide wire identification member 666 is formed at the guidewire fixture 665 at the center of the base end portion. Further, a guidewire fixing portion 678 for receiving the guide wire 630 is formed atthe end portion on the end side of the guide wire fixture 665.

Incidentally, it is more preferable to attach an elastic member such asrubber to the guide wire fixing portion 678 in order to increase thefriction between the guide wire fixing portion 678 and the guide wire630 and prevent the guide wire 630 from being damaged.

Furthermore, shoulder portions 679 which hustle against the movementrestriction portion 669 of the base member 664 of the guide wire fixingmember main body 662 and slit-like stopper impingement portions 680 forreceiving the stopper member 675 are respectively formed in the middleof the guide wire fixture 665 on the both sides.

Moreover, as shown in FIGS. 95B and 95C, the guide wire identificationmember 666 is a substantially tabular member which has a longitudinaldimension of approximately 10 mm, a transverse dimension ofapproximately 4 mm and a thickness of approximately 0.4 mm, and amaterial thereof is stainless steel.

Incidentally, the guide wire identification member 666 is not restrictedto stainless steel if it has an enough board thickness and can maintainthe rigidity. Any other metal material such as aluminium or hard resinsuch as acrylic, polycarbonate or ABS resin may be used.

A therapeutic instrument receiving portion 681 is formed at the endportion of the guide wire identification member 666. A guide wireinsertion groove 682 which is opened on the end side and has a width ofapproximately 1 mm is formed at the central position of the therapeuticinstrument receiving portion 681. In addition, the therapeuticinstrument receiving portion 681 is configured to receive thetherapeutic instrument 619 other than the guide wire 630.

It is to be noted that fluorine coating and the like may be applied tothe therapeutic instrument receiving portion 681 in order to reduce thefriction with respect to the therapeutic instrument 619 and an end ofthe therapeutic instrument 681 may be R-chamfered.

Additionally, a thrusting portion 683 which is bent in the substantiallyL shape as shown in FIG. 95C is formed at the base end portion of theguide wire identification member 666. Further, a large width portion 684having a large lateral width is formed in the middle of the guide wireidentification portion 666 at a substantially central part thereof.Furthermore, shoulder portions 85 which hustle against the movementrestriction portion 669 of the base member 664 in the guide wire fixingmember main body 662 are formed on the both sides of the large widthportion 684 on the end portion side, and smoothly curved stopperreleasing portions 686 are formed on the both sides of the same on thebase end portion side, respectively.

Moreover, a concave portion 687 having a depth of approximately 0.2 mmis formed at the large width portion 684 of the guide wireidentification member 666. A slit 688 through which a click pin 671 isinserted is formed in the concave portion 687.

In addition, as shown in FIG. 93B, the guide wire identification member666 is arranged on the guide groove 668 on the front surface side of thebase member 664 of the guide wire fixing member main body 662, and theguide wire fixture 665 is arranged on the guide wire identificationmember 666. Therefore, the guide wire identification member 666 isarranged in such a manner that it is sandwiched between the base member664 of the guide wire fixing member main body 662 and the guide wirefixture 665.

The end side of the guide wire fixture 665 is caused to protrude fromthe base member 664 of the guide wire fixing member main body 662 so asto be capable of moving forward/backward. Additionally, the end side ofthe guide wire fixture 665 reaches the channel opening portion 615 onthe end portion 603 side of the insertion portion 602 in the endoscope601.

It is to be noted that the end side of the guide wire identificationmember 666 is attached in such a manner that it is caused to protrude onthe end side away from the guide wire fixture 665 so as to be capable ofmoving forward/backward.

Further, when the guide wire identification member 666 moves in thedirection along which it protrudes from the guide groove 668 of the basemember 664 to the outer side, the thrusting portion 683 of the guidewire identification member 666 is engaged with the impingement portion677 of the guide wire fixture 665 in the hooked manner.

Furthermore, a stopper member 675 for causing the guide wireidentification member 666 to interlock with the guide wire fixture 665is fixed to the stopper fixing groove 76 provided on the back surfaceside of the base member 664 of the guide wire fixing member main body662. As shown in FIGS. 95D and 95E, the stopper member 675 is two thinwire rods each having a wire diameter of approximately 0.2 mm, andsuperelastic alloy manufactured by NiTi is desirable for a materialthereof. However, any other metal, e.g., stainless steel or hard resinsuch as acrylic or polycarbonate may be used as long as it is a wire rodhaving the elasticity.

Moreover, a linear portion 675 a having a substantially rectilinearshape is formed at the part of the thin wire rod of the stopper member675 which is arranged on the back surface side of the base member 664 ofthe guide wire fixing member main body 662. In addition, one end portionside of the stopper member 675 is extended to the front surface side ofthe base member 664 through the stopper insertion hole 673 opened on theend side of the base member 664 of the guide wire fixing member mainbody 662. In addition, a bent portion 675 b which is bent in thesubstantially L shape is formed at the extended portion on the frontsurface side of the base member 664. Additionally, the end part of thebent portion 675 b of the stopper member 675 is bent in the directionaway from the base member 664 of the guide wire fixing member main body662 so that the end part can reach the guide wire fixture 665 across theguide wire identification member 666.

Additionally, the bent portion 675 b of the stopper member 675 isbrought into contact with the stopper releasing portion 686 of the guidewire identification member 666, and the guide wire identification member666 is configured to use the stopper releasing portion 686 to extend thespace between the bent portions 675 b in the horizontal direction.

Further, as shown in FIGS. 93A and 93B, a top cover 667 is provided onthe front surface side of the guide wire fixing member main body 662. Aspring fixing pin 89 is provided so as to protrude on the end side ofthe top cover 667, and a window portion 90 from which the thrustingportion 683 of the guide wire identification member 666 protrudes isformed on the base end portion side of the top cover 667.

Furthermore, a spring member 691 as a torsion bar for giving impetus tothe guide wire identification member 666 in the direction along whichthe guide wire identification member 666 is pushed to the end portionside of the base member 664 is provided to the top cover 667. One endportion of the spring member 691 is fixed to the spring fixing pin 89,and the other end portion of the same is engaged with the thrustingportion 683 of the guide wire identification member 666.

Incidentally, it is desirable that the wire diameter of the wire strandof the spring member 691 is, e.g., approximately 0.2 mm and the materialthereof is superelastic alloy manufactured by NiTi.

Moreover, the click mechanism 670 for temporarily fixing the guide wireidentification member 666 is provided to the guide wire fixing membermain body 662 according to this embodiment. To the click mechanism 670are provided a click pin 671 shown in FIG. 98A and a click groove 672set to the base member 664 of the guide wire fixing member main body662.

Although the material of the click pin 671 is stainless steel, theelasticity is not necessarily required if the material is strong to someextent, and hard resin may be used.

Incidentally, although a circular shape may be used as thecross-sectional shape of the click pin 671, a rectangular shape and thelike by which the click pin 671 is hard to be inclined with respect tothe click groove 672 is desirable.

In addition, a U-shaped bent portion 671 a which is bent in thesubstantially U shape is formed at one end portion of the click pin 671.Additionally, an L-shaped bent portion 671 b which is bent in thesubstantially L shape is formed at the other end portion of the clickpin 671. Further, the U-shaped bent portion 671 a of the click pin 671is rotatably attached to the slit 688 of the guide wire identificationmember 666. Furthermore, the L-shaped bent portion 671 b of the clickpin 671 is movably inserted into the click groove 672 of the base member664.

It is to be noted that an edge portion 671 c which is smoothly roundedso that it can smoothly move in the click groove 672 for guiding the pinis formed at the pin end portion of the click pin 671 on the L-shapedbent portion 671 b side.

Moreover, the shape of the click groove 672 of the base member 664 isset as shown in FIG. 98B. That is, the click groove 672 is formed into adistorted ring shape connecting an end side convex portion 672 b whichis arranged on the end side of the base member 664 and provided with onelinear portion 672 an extending in the substantially axial direction,two rear end side convex portions 672 c and 672 d arranged on the rearend side of the base member 664 side by side, and a concave portion 672e arranged between the two rear end side convex portions 672 c and 672d. In addition, when the guide wire fixture 665 protrudes from the guidegroove 668 of the base member 664 of the guide wire fixing member mainbody 662, the click pin 671 is arranged on the end side convex portion672 b side. When the guide wire fixture 665 is embedded in the guidegroove 668 of the base member 664 of the guide wire fixing member mainbody 662, the click pin 671 is arranged on the side of the two rear endside convex portions 672 c and 672 d.

Additionally, the inner wall of the click groove 672 is smooth along theentire length. Taking the allowance of the click pin 671 intoconsideration, approximately 0.25 mm is desirable for the groove widthof the click groove 672, and the depth of the same is set so as to varyin a range of approximately 0.4 mm to 0.2 mm as follows. That is, thedepth of the linear portion 672 a of the click groove 672 on the endside is set to approximately 0.4 mm. A left groove 672 f and a rightgroove 672 g obtained by bifurcation are connected to the end portion ofthe linear portion 672 a. The depth of the left groove 672 f does notvary at the bifurcated portion, and it is set to approximately 0.4 mm.

Further, the depth of the right groove 672 g discontinuously varies at adiscontinuous point 672 h and is set to approximately 0.2 mm.

Furthermore, after being bifurcated, the depth of the left groove 672 fbecomes shallow to 0.2 mm and reaches the rear end side convex portion672 c on the left side.

The depth of the rear end side convex portion 672 c on the left sidebecomes deep to approximately 0.4 mm at the discontinuous point 672 i.

Moreover, the depth of the click groove 672 becomes discontinuouslyshallow to 0.2 mm from the rear end side convex portion 672 c on theleft side and reaches the concave portion 672 e. The depth of theconcave portion 672 e discontinuously varies at the discontinuous point672 j and is set to 0.4 mm. Then, the depth of the click groove 672becomes discontinuously shallow to 0.2 mm and reaches the rear end sideconvex portion 672 d on the right side. The depth of the rear end sideconvex portion 672 d on the right side becomes discontinuously varies atthe discontinuous point 672 k and is set to 0.4 mm.

In addition, the click groove 672 extends from the rear end side convexportion 672 d on the right side to the end side and becomes the rightgroove 672 g. Also, the depth of the click groove 672 becomescontinuously shallow to 0.2 mm and runs together with a bifurcation atthe dead end portion of the linear portion 672 a.

Additionally, as shown in FIGS. 92A, 97A and 97B, asubstantially-C-shaped belt-like attachment portion 693 having adiscontinuous notch portion 692 at a part of the ring is provided to theattachment member 663. The belt shape of the belt-like attachmentportion 693 is a zonal member having a width of approximately 10 mm anda thickness of approximately 0.5 mm.

Further, a mucous protection portion 694 for preventing the guide wirefixing member 661 from being caught by the mucous is provided to thebelt-like attachment portion 693 so as to protrude therefrom. Thismucous protection portion 694 is arranged on the opposite side to theobservation window 614 of the endoscope 601.

Furthermore, a positioning convex portion 95 which is fitted in thechannel opening portion 615 of the end portion 603 when attached to theendoscope 601 is provided to the attachment member 663 so as to protrudetherefrom. Moreover, as shown in FIG. 92A, substantially-L-shapedengagement convex portions 696 which are fitted in the engagement groove674 provided on the back surface side of the base member 664 of theguide wire fixing member main body 662 are provided on the both ends ofthe discontinuous notch portion 692 in the belt-like attachment portion693 so as to protrude therefrom.

Incidentally, although polycarbonate is desirable as a material of theattachment member 663, any other resin such as rubber or metal such asstainless steel can suffice if it has the strength and its surface issmoothed so as not to damage the endoscope 601.

The effect of this embodiment will now be described. Description willfirst be given as to the operation for attaching the guide wire fixingmember 661 according to this embodiment to the end portion 603 of theinsertion portion 602 of the endoscope 601. In the operation forattaching the guide wire fixing member 661, the convex portion 95 usedfor positioning the attachment member 663 is fitted in the channelopening portion 615 of the endoscope 601. Subsequently, thediscontinuous notch portion 692 of the belt-like attachment portion 693of the attachment member 663 being butted, the engagement convex portion696 of the attachment member 663 is fitted in the engagement groove 674of the guide wire fixing member main body 662. At this moment, as shownin FIG. 91, the guide wire fixing member 661 is slid from the end sideof the belt-like attachment portion 693, and the guide wire fixingmember 661 is fixed to the end portion 603 of the insertion portion 602in the endoscope 601.

In addition, in the case of inserting the end portion 603 of theendoscope 601 having the guide wire fixing member 661 being attachedthereto into a celoma, as shown in FIG. 92B, the mucous 697 is notcaught by the guide wire fixing member main body 662 since the mucousprotection portion 694 of the guide wire fixing member 661 thrusts awaythe mucous 697 in the celoma.

Additionally, when the therapeutic instrument 619 such as a tube otherthan the guide wire 630 is inserted into the therapeutic instrumentinsertion channel 616 on the operation portion 606 side of the endoscope601 and is used with the end portion 603 of the endoscope 601 beinginserted into a celoma, the end portion of the therapeutic instrument619 is caused to protrude from the channel opening portion 615 of theend portion 603 of the insertion portion 602 in the endoscope 601. Inthe initial state, the therapeutic instrument elevator base 617 is heldat the standby position (set-down position) shown in FIGS. 101A and101B, and the guide wire fixing member main body 662 is held in thestate depicted in FIGS. 99A and 99B.

At this moment, impetus is given to the guide wire identification member666 of the guide wire fixing member 661 in the direction along which itis pushed to the end portion side of the base member 664 by the springforce of the spring member 691, and the thrusting portion 683 of theguide wire identification member 666 is held in the state that ithustles against the impingement portion 677 of the guide wire fixture665. Then, the click pin 671 is held in the state it is being insertedin the linear portion 672 a on the end side of the click groove 672.

Further, in case of raising the therapeutic instrument 619 from theinitial state, the following operation is conducted. The therapeuticinstrument elevator base 617 of the end portion 603 of the insertionportion 602 is first swiveled in the elevator operation direction bymanipulating the non-illustrated therapeutic instrument elevator baseoperation lever of the operation portion 606 of the endoscope 601. Then,the end portion of the therapeutic instrument 619 is thrusted in thedirection for raising the therapeutic instrument which is orthogonal tothe axial direction of the insertion portion 602 by the therapeuticinstrument elevator base 617 with the swivel operation of thetherapeutic instrument elevator base 617.

At this moment, the end portion of the therapeutic instrument 619 whichis thrusted by the therapeutic instrument elevator base 617 is broughtinto contact with the therapeutic instrument receiving portion 681 ofthe guide wire identification member 666 in the middle of the swiveloperation of the therapeutic instrument elevator base 617. Thus, theguide wire identification member 666 is thrusted down to the base endside of the endoscope 601 by the subsequent swivel operation of thetherapeutic instrument elevator base 617.

Furthermore, with the operation by which the guide wire identificationmember 666 is thrusted down to the base end side of the endoscope 601,the stopper member 675 is outthrusted from side to side along thestopper releasing portion 686 of the guide wire identification member666. At this moment, when the stopper member 675 moves to the dead endposition along the stopper releasing portion 686 of the guide wireidentification member 666, the stopper member 675 comes off the stopperimpingement portion 680 of the guide wire fixture 665 as shown in FIG.99C. Therefore, since the stopper of the guide wire fixture 665 isreleased in this state, the guide wire fixture 665 is also thrusted downto the base end side of the endoscope 601 together with the guide wireidentification member 666.

Then, when the end portion of the therapeutic instrument 619 is thrustedin the therapeutic instrument set-up direction orthogonal to the axialdirection of the insertion portion 602 by the therapeutic instrumentelevator base 617 as shown in FIGS. 101C and 101D, the guide wireidentification member 666 is pushed to the maximum thrust position inthe guide groove 668 of the base member 664 as illustrated in FIG. 99D.At this moment, the click pin 671 moves along the left groove 672 f ofthe click groove 672 in cooperation with the guide wire identificationmember 666 and reaches the rear end side convex portion 672 c on theleft side.

Thereafter, by carrying out the operation for returning the therapeuticinstrument elevator base 617 in the direction toward the standbyposition (set-down position) shown in FIG. 101A, the guide wireidentification member 666 is pushed back in the direction of the end ofthe insertion portion 602 by the spring force of the spring member 691as depicted in FIGS. 101E and 101F. At the same time, as shown in FIG.100A, the click pin 671 connected to the guide wire identificationmember 666 moves to the position of the concave portion 672 e along theclick groove 672, and the guide wire fixture 665 and the guide wireidentification member 666 are held in the thrusted state.

At this moment, since the click pin 671 has passed the discontinuouspoint 672 iat the rear end side convex portion 672 on the left side, itdoes not rotate in the opposite direction.

It is to be noted that the similar reverse rotation prevention effect isprovided at all the discontinuous points in the click groove 672.

In this state, the guide wire fixture 665 and the guide wireidentification member 666 do not interfere with the therapeuticinstrument 619, and the guide wire fixture 665 and the guide wireidentification member 666 do not obstruct in the visual filed of theobservation window 614 of the endoscope 601.

Moreover, when the therapeutic instrument 619 is again raised, the guidewire fixture 665 and the guide wire identification member 666 are againthrusted down to the maximum thrust position in the guide groove 668 ofthe base member 664 as shown in FIGS. 101C and 101D. At this moment, asillustrated in FIG. 101B, the click pin 671 reaches the rear end sideconvex portion 672 d on the right side along the click groove 672 andthe locked state is released.

Thereafter, when the operation for returning the therapeutic instrumentelevator base 617 in the direction toward the standby position (set-downposition) shown in FIG. 101A is performed, the guide wire identificationmember 666 is pushed back in the direction toward the end of theinsertion portion 602 by the spring force of the spring member 691. Atthe same time, with the movement of the guide wire identification member666 at this moment, the thrusting portion 683 of the guide wireidentification member 666 is caused to hustle against the impingementportion 677 of the guide wire fixture 665 as depicted in FIG. 100C. As aresult, the guide wire fixture 665 is also thrusted to the end side ofthe endoscope 601 together with the guide wire identification member666, thereby returning to the initial state shown in FIGS. 99A and 99B.

In addition, as illustrated in FIGS. 102A and 102B, with the end portionof the guide wire 630 being led out from the channel opening portion 615of the endoscope 601 (initial state), when the therapeutic instrumentelevator base 617 is raised, the following operation is carried out.

That is, when the therapeutic instrument elevator base 617 at the endportion 603 of the insertion portion 602 from the initial state iscaused to swivel, the guide wire 630 is inserted into the guide wireinsertion groove 682 provided to the therapeutic instrument receivingportion 681 at the end of the guide wire identification member 666 bythe therapeutic instrument elevator base 617 with the swivel operationof the therapeutic instrument elevator base 617 at this moment. Thus,the guide wire identification member 666 is not thrusted down by theguide wire 630 in this case.

Additionally, as shown in FIGS. 102C and 102D, the guide wire 630inserted into the guide wire insertion groove 682 of the therapeuticinstrument receiving portion 681 by swiveling of the therapeuticinstrument elevator base 617 directly hustles against the guide wirefixing portion 678 of the guide wire fixture 665.

At this moment, since the guide wire fixture 665 is restricted by thestopper member 675 at the stopper impingement portion 680 as shown inFIG. 99A, it is not thrusted down, and the guide wire 630 is pressedbetween the therapeutic instrument elevator base 617 and the guide wirefixture 665 and fixed in the engaged state.

Incidentally, when releasing engagement of the guide wire 630, it isgood enough to effect the operation for returning the therapeuticinstrument elevator base 617 in the direction toward the standbyposition (set-down position) shown in FIGS. 102A and 102B.

The following advantage can be demonstrated in this embodiment. That is,in this embodiment, the therapeutic instrument 619 other than the guidewire 630 can be operated to be raised or moved forward/backward bymanipulation of the therapeutic instrument elevator base 617 as in theprior art, and only the guide wire 630 is sandwiched between thetherapeutic instrument elevator base 617 and the guide wire fixture 665and fixed in the engaged manner by manipulation of the therapeuticinstrument elevator base 617. Therefore, in case of the operation forreplacing the therapeutic instrument 619, the necessity to grip theguide wire 630 on the operation portion 606 side of the endoscope 601 asin the prior art can be eliminated by engaging only the guide wire 630between the therapeutic instrument elevator base 617 and the guide wirefixture 665 by manipulating the therapeutic instrument elevator base617. Accordingly, since there is as advantage that the operation forreplacing the therapeutic instrument 619 is facilitated also in thisembodiment as in the 40th embodiment, the operation time required forreplacing the therapeutic instrument 619 can be reduced.

Also, in addition to the advantage similar to that of the 40thembodiment, this embodiment has an advantage that actuation of the guidewire identification member 666 is secure and the visual field of theobservation window 614 of the endoscope 601 can be further widelyassured.

Further, FIGS. 103A to 103J and FIGS. 107A to 107D show a 43rdembodiment according to the present invention. In this embodiment, thestructure of the guide wire fixing member main body 662 in the guidewire fixing member 661 according to the 42nd embodiment is changed asfollows.

Incidentally, parts other than the above have the structure equal tothat of the 42nd embodiment, and like reference numerals denote partssimilar to those of the 42nd embodiment, thereby omitting theirexplanation.

That is, to the guide wire fixing member main body 662 according to thisembodiment are provided a guide wire fixture 701 show in FIG. 103D and aguide wire identification member 702 depicted in FIGS. 103E and 103Fwhich have the structures different from those of the guide wire fixture665 and the guide wire identification member 666 according to the 42ndembodiment.

A substantially-V-shaped guide wire engagement groove 703 whose width issmaller than the outside diameter dimension of the guide wire 630 isformed at the end portion of the guide wire fixture 701 according tothis embodiment. Furthermore, a stopper impingement portion 704 forreceiving a later-described stopper member is provided at a central partof the guide wire fixture 701 on the base end portion side.

Moreover, a large width portion 705 having a large transverse width isformed in the middle of the guide wire fixture 701. In addition,shoulder portions 106 which hustle against the movement restrictionportion 669 of the base member 664 are formed on the both sides of thelarge width portion 705 on the end portion side, and guide wireidentification member impingement portions 707 are formed on the bothsides of the large width portion 705 on the base end portion side.

Additionally, the guide wire identification member 702 according to thisembodiment is configured as shown in FIGS. 103E and 103F. A therapeuticinstrument receiving portion 708 is formed at the end portion of theguide wire identification member 702. A guide wire insertion groove 709which is opened on the end side is formed at a central part of thetherapeutic instrument receiving portion 708. Further, the therapeuticinstrument receiving portion 708 is configured to receive thetherapeutic instrument 619 other than the guide wire 630.

Further, a large width portion 710 having a large transverse width isformed on the base end portion side of the guide wire identificationmember 702. Furthermore, shoulder portions 711 which hustle against themovement restriction portion 669 of the base member 664 in the guidewire fixing member main body 662 are formed on the both sides of thelarge width portion 710 on the end portion side.

Moreover, a bifurcated edge portion 712 which is bifurcated as shown inFIG. 103E is formed at the base end portion side of the large widthportion 710. As shown in FIG. 103F, to the bifurcated edge portion 712are formed stopper releasing portions 713 each of which has a boardthickness smoothly changing into a wall thickness from the base endportion side to the end portion side. In addition, a thrusting portion744 for the guide wire fixture 701 is formed at a step portion at theend of each stopper releasing portion 713. Additionally, when the guidewire identification member 702 protrudes, a guide wire identificationmember impingement portion 707 of the guide wire fixture 701 isconfigured to receive the thrusting portion 714 for the guide wireidentification member 702.

It is to be noted that at the large width portion 710 of the guide wireidentification member 702 are formed a concave portion 715 and a slit716 which are similar to the concave portion 687 and the slit 688 of theguide wire identification member 666 according to the 42nd embodiment.

Further, FIGS. 103A to 103C show the base member 664 of the guide wirefixing member main body 662 according to this embodiment. To the endportion of the base member 664 on the front surface side is attached asubstantially-T-shaped stopper member 717 which has a top cover functionfor covering the guide wire fixture 701 and causes the guide wireidentification member 702 and the guide wire fixture 701 to interlockwith each other as shown in FIG. 103G.

This stopper member 717 is a platy member having a board thickness ofapproximately 0.2 mm, and superelastic alloy manufactured by NiTi isdesirable as a material thereof. However, a member having the elasticitysuch as stainless steel can suffice.

A fixing portion 717 a which is fixed on the end portion on the frontsurface side of the base member 664 of the guide wire fixing member mainbody 662 is provided on the end side of the stopper member 717.Furthermore, as shown in FIG. 103H, a bent portion 717 b which is bentat substantially 90 degrees is provided to the base end portion of thestopper member 717. The bent portion 717 b is in contact with thestopper impingement portion 704 of the guide wire fixture 701.

Moreover, a click mechanism 718 having a structure different from thatof the click mechanism 670 according to the 42nd embodiment is providedon the base end portion side of the guide groove 668 of the base member664. To the click mechanism 718 are provided a click pin 719 shown inFIG. 103I which has the same structure as the click pin 671 according tothe 42nd embodiment and a click groove 720 shown in FIG. 103J which isarranged on the base end portion side of the guide groove 668 in thebase member 664 of the guide wire fixing member main body 662.

In addition, a U-shaped bent portion 719 a which is bent in thesubstantially U shape is formed at one end portion of the click pin 719.Additionally, an L-shaped bent portion 719 b which is bent in the Lshape at substantially right angles is formed at the other end portionof the click pin 719. Further, the U-shaped bent portion 719 a of theclick pin 719 is rotatably attached to the slit 716 of the guide wireidentification member 702. Furthermore, the L-shaped bent portion 719 bof the click pin 719 is movably inserted into the click groove 720 ofthe base member 664.

An edge portion 719 c which is smoothly rounded so as to smoothly movein the click groove 720 for guiding the pin is formed at the pin endportion of the click pin 719 on the L-shaped bent portion 719 b side.

Moreover, the shape of the click groove 720 of the base member 664 isset as shown in FIG. 103J. That is, the click groove 720 is formed intoa substantially triangular distorted ring shape including a groove endportion 720 a arranged on the end side of the base member 664, a grooverear end portion 720 b arranged on the rear end side of the base member664, a linear groove portion 720 c connecting the groove end portion 720c and the groove rear end portion 720 b to each other, a hole portion720 d arranged on the side of the linear groove portion 720 c, a lineargroove portion 720 e connecting the hole portion 720 d and the grooveend portion 720 a to each other, and a linear groove portion 720 fconnecting the hole portion 720 d and the groove rear end portion 720 bto each other. In addition, when the guide wire fixture 701 protrudesfrom the guide groove 668 of the base member 664 of the guide wirefixing member main body 662, the click pin 719 is arranged on the grooveend portion 720 a side. Also, when the guide wire fixture 701 isembedded in the guide groove 668 of the base member 664 of the guidewire fixing member main body 662, the click pin 719 is arranged on thegroove rear end portion 720 b side.

Description will now be given as to the detailed structure of the shapeof the click groove 720 of the base member 664. That is, the depth ofthe linear groove portion 720 e connecting the groove end portion 720 aand the hole portion 720 d of the click groove 720 is set toapproximately 0.4 mm. The depth of the hole portion 720 d is set toapproximately 0.6 mm. Further, the distance between the hole portion 720d and the groove rear end portion 720 b is set to approximately 0.5 mm.Furthermore, the depth becomes continuously shallow between the holeportion 720 d and the groove rear end portion 720 b and is set to 0.2mm. The click groove 720 discontinuously has the depth of 0.4 mm at thediscontinuous point 720 g of the groove rear end portion 720 b. Then,this groove extends from the groove rear end portion 720 b to the endside along the liner groove portion 720 c and its depth becomescontinuously shallow to 0.2 mm. Also, it runs together with the grooveend portion 720 a on the end side through the discontinuous point 720 h.

The effect of the guide wire fixing member main body 662 according tothis embodiment will now be described. FIGS. 106A to 106F show theoperation state when the therapeutic instrument 619 other than the guidewire 630 is raised by using the guide wire fixing member 661, and FIGS.107A to 107D show the operation state when the guide wire 630 is raisedby using the guide wire fixing member 661.

Description will be first given as to the case where the therapeuticinstrument 619 other than the guide wire 630 is raised. When thetherapeutic instrument 619 such as a contrasting tube other than theguide wire 630 is inserted into the therapeutic instrument insertionchannel 616 on the operation portion 606 side of the endoscope 601 andused with the end portion 603 of the endoscope 601 being inserted into aceloma, the end portion of the therapeutic instrument 619 is caused toprotrude from the channel opening portion 615 at the end portion 603 ofthe insertion portion 602 in the endoscope 601. In the initial state,the therapeutic instrument elevator base 617 is held at the standbyposition (set-down position) shown in FIGS. 106A and 106B, and the guidewire fixing member 661 is held in the state depicted in FIGS. 104A and104B.

At this moment, impetus is given to the guide wire identification member702 of the guide wire fixing member 661 in the direction for thrustingto the end portion side of the base member 664 by the spring force ofthe spring member 691, and the thrusting portion 714 of the guide wireidentification member 702 is held in such a manner that it is caused tohustle against the guide wire identification member impingement portion707 of the guide wire fixture 701. Moreover, the click pin 719 is heldbeing inserted in the groove end portion 720 a on the end side of theclick groove 720.

In addition, in case of raising the therapeutic instrument 619 from theinitial state, the following operation is conducted. The therapeuticinstrument elevator base 617 at the end portion 603 of the insertionportion 602 is first swiveled in the elevator operation direction bymanipulating the non-illustrated therapeutic instrument elevatoroperation lever of the operation portion 606 in the endoscope 601. Then,with the swivel operation of the therapeutic instrument elevator base617, the end portion of the therapeutic instrument 619 is thrusted inthe direction for raising the therapeutic instrument which is orthogonalto the axial direction of the insertion portion 602 by the therapeuticinstrument elevator base 617.

At this moment, the end portion of the therapeutic instrument 619thrusted by the therapeutic instrument elevator base 617 is brought intocontact with the therapeutic instrument receiving portion 708 of theguide wire identification member 702 in the middle of the swiveloperation of the therapeutic instrument elevator base 617. Thus, theguide wire identification member 702 is thrusted down to the base endside of the endoscope 601 by the subsequent swivel operation of thetherapeutic instrument elevator base 617.

Additionally, with the operation for thrusting down the guide wireidentification member 702 to the base end side of the endoscope 601, thebent portion 717 b of the stopper member 717 is pushed up in a directionalong which it moves away from the stopper impingement portion 704 ofthe guide wire fixture 701 by the stopper releasing portion 713 of theguide wire identification member 702. At this moment, when the stoppermember 717 moves to the dead end position along the stopper releasingportion 713 of the guide wire identification member 702, the stoppermember 717 comes off the stopper impingement portion 704 of the guidewire fixture 701 as shown in FIG. 104D. Therefore, since the stopper ofthe guide wire fixture 701 is released in this state, the guide wirefixture 701 is also thrusted down to the base end side of the endoscope601 together with the guide wire identification member 702. At thismoment, the click pin 719 moves along the linear groove portion 720 e ofthe click groove 720 on the left side in FIG. 103J in cooperation withthe guide wire identification member 702.

Then, when the end portion of the therapeutic instrument 619 is thrustedin the direction for raising the therapeutic instrument which isorthogonal to the axial direction of the insertion portion 602 by thetherapeutic instrument elevator base 617 as shown in FIGS. 106C and106D, the guide wire identification member 702 is pushed into the guidegroove 668 of the base member 664 to the thrust position shown in FIGS.104E and 104F. At this moment, the click pin 719 reaches the holeportion 720 d. The click pin 719 is caught by the hole portion 720 d andfixed in the engaged state. Therefore, the guide wire fixture 701 andthe guide wire identification member 702 are held in the thrusted stateas shown in FIGS. 104E and 104F.

When the therapeutic instrument elevator base 617 is lowered a littlefrom this state, the guide wire fixture 701 and the guide wireidentification member 702 do not interfere with the therapeuticinstrument 619, and the guide wire fixture 701 and the guide wireidentification member 702 do not obstruct in the visual field of theobservation window 614 of the endoscope 601.

Further, when the therapeutic instrument 619 is again set-up, the guidewire fixture 701 and the guide wire identification member 702 arethrusted down to the maximum thrust position in the guide groove 668 asshown in FIGS. 105A and 105B. At this moment, the click pin 719 movesout of the hole portion 720 d of the click groove 720 and reaches thegroove rear end portion 720 b along the linear groove portion 720 f,thereby releasing the locked state.

Thereafter, when the operation for returning the therapeutic instrumentelevator base 617 to the direction of the standby position (set-downposition) shown in FIGS. 106A and 106B is carried out, the guide wireidentification member 702 is pushed back to the direction of the end ofthe insertion portion 602 by the spring force of the spring member 691.At the same time, with the moving operation of the guide wireidentification member 702 at this moment, the thrusting portion 714 ofthe guide wire identification member 702 is caused to hustle against theimpingement portion 707 of the guide wire fixture 701 as shown in FIGS.105C and 105D. As a result, the guide wire fixture 701 is also pushed tothe end side of the endoscope 601 together with the guide wireidentification member 702 and returns to the initial state shown inFIGS. 104A and 104B.

Furthermore, as shown in FIGS. 107A and 107B, when the therapeuticinstrument elevator base 617 is raised with the end portion of the guidewire 630 being led out from the channel opening portion 615 of theendoscope 601 (initial state), the following operation is performed.

That is, when the therapeutic instrument elevator base 617 of the endportion 603 of the insertion portion 602 is operated to swivel from theinitial state mentioned above, the guide wire 630 is inserted in theguide wire insertion groove 709 of the therapeutic instrument receivingportion 708 provided at the end of the guide wire identification member702 by the therapeutic instrument elevator base 617 with the swivelingoperation of the therapeutic instrument elevator base 617 at thismoment. Therefore, in this case, the guide wire identification member702 is not thrusted down by the guide wire 630.

Moreover, the guide wire 630 existing in the guide wire insertion groove709 of the therapeutic instrument receiving portion 708 reaches theposition of the end portion 701 a of the guide wire fixture 701 byswiveling of the therapeutic instrument elevator base 617. At thismoment, since the guide wire identification member 702 is not thrusteddown, the guide wire fixture 701 is restricted with the stopper member717 being engaged with the stopper impingement portion 704 and hence itis not thrusted down.

In addition, when the therapeutic instrument elevator base 617 isoperated to be raised, the guide wire 630 is pressed against the guidewire engagement groove 703 of the end portion 701 a of the guide wirefixture 701 by the therapeutic instrument elevator base 617 and fixed insuch a manner that it is held by and engaged with the guide wireengagement groove 703 as shown in FIGS. 107C and 107D.

Incidentally, when releasing engagement of the guide wire 630, thetherapeutic instrument 619 is inserted with the guide wire 630 beingused as a guide and caused to protrude from the channel opening portion615 at the end portion 603 of the insertion portion 602 in the endoscope601. As a result, the therapeutic instrument 619 pushes out the guidewire 630 in the direction along which the guide wire 630 comes off theguide wire engagement groove 703, thereby releasing engagement.

The following advantage can be obtained in this embodiment. That is, inthis embodiment, the therapeutic instrument 619 other than the guidewire 630 can be operated to be raised or moved forward/backward bymanipulation of the therapeutic instrument elevator base 617 as in theprior art, and only the guide wire 630 is pressed against the guide wireengagement groove 703 at the end portion 701 a of the guide wire fixture701 by the therapeutic instrument elevator base 617 and fixed so as tobe held by and engaged with the guide wire engagement groove 703.Therefore, in case of the operation for replacing the therapeuticinstrument 619, the necessity of gripping the guide wire 630 on theoperation portion 606 side of the endoscope 601 as in the prior art canbe eliminated by engaging only the guide wire 630 with the guide wireengagement groove 703 at the end portion 701 a of the guide wire fixture701 by manipulating the therapeutic instrument elevator base 617.Accordingly, since the operation for replacing the therapeuticinstrument 619 can be facilitated also in this embodiment as in the 40thembodiment, the operation time required for replacing the therapeuticinstrument 619 can be reduced.

Also, in addition to the advantage similar to that of the 40thembodiment, this embodiment has an advantage that a number ofconstituent components of the guide wire fixing member main body 662 canbe reduced and the operation for assembling the guide wire fixing membermain body 662 can be facilitated.

In addition, FIGS. 108A to 108E show a 44th embodiment according to thepresent invention. In this embodiment, a guide wire fixing member 731having a structure different from that of the guide wire fixing member621 according to the 40th embodiment is provided to the end portion 603of the insertion portion 602 of the side viewing type endoscope 601 inthe endoscope apparatus according to the 40th embodiment.

That is, in this embodiment, an external channel 732 is provided alongthe side surface of the insertion portion 602 in the endoscope 601 overthe substantially entire length of the insertion portion 602. The endportion of the external channel 732 is arranged at a part in thevicinity of the channel opening portion 615 provided at the end portion603 of the insertion portion 602. Additionally, the base end portion ofthe external channel 732 is arranged at a part in the vicinity of theoperation portion 606 (see FIGS. 114A and 114B) in the endoscope 601.

Further, the guide wire fixing member 731 according to this embodimentis inserted into the external channel 732 so as to be capable of movingforward/backward therein without restraint. FIG. 108A shows an examplein which a gripping therapeutic instrument 733 is used as the guide wirefixing member 731. Furthermore, FIG. 108B shows an example in which asnare 734 is used as the guide wire fixing member 731, and FIG. 108Cshows an example in which a guide wire thruster 735 is used as a guidewire fixing member 731.

Moreover, although a porous PTFE is desirable as a material of theexternal channel 732, the material is not restricted to porous PTFE aslong as it has a nearly equal hardness and buckling resistant property.If the material of the external channel 732 is hard, the externalchannel 732 may buckle or the stiffness of the insertion portion 602 mayincrease depending on the insertion shape of the endoscope 601, therebyreducing the insertion ability.

On the contrary, if the material of the external channel 732 is soft,the amount of force needed for advance or retreat of the guide wirefixing member 731 is increased. Therefore, the hardness of the externalchannel 732 can be set to the appropriate state by forming the externalchannel 732 by using porous PTFE.

As to the dimensions of the inside and outside diameters of the externalchannel 732, the small outside diameter is preferable when taking intoconsideration the insertion ability into a celoma. On the other hand,however, when the outside diameter dimension of the guide wire fixingmember 731 to be inserted into the external channel 732 is taken intoaccount, a diameter of at least approximately 3 mm is necessary, and itis desirable to set the inside diameter to approximately 3 mm and theoutside diameter to approximately 4 mm, for example.

Incidentally, an arm portion 737 which is a gripping portion and can beopened/closed is provided on the gripping therapeutic instrument 733 ofthe guide wire fixing member 731 at the end portion of the operationwire 736. In addition, the arm portion 737 is configured to hold theguide wire 630 therein. Additionally, as shown in FIG. 108D, zigzaggrooves 737 a or irregular grooves 737 b to prevent slipping which aresubstantially orthogonal to the axial direction of the guide wire 630are formed on the contact plane in the arm portion 737 with respect tothe guide wire 630. The grooves on the contact plane in the arm portion737 with respect to the guide wire 630 may be formed in the staggeredmanner so that the opposed grooves can be fitted to each other.

Further, as shown in FIG. 108E, the contact plane with which the guidewire 630 is brought into contact may be covered with resin such asrubber 737 c.

It is to be noted that a loop-like snare wire 738 is provided for thesnare 734 shown in FIG. 108B at the end portion of the operation wire736 b. The snare wire 738 is configured to grip the guide wire 630therein. Furthermore, a tabular thrusting plate 739 is provided to theguide wire thruster 735 shown in FIG. 108C at the end portion of theoperation wire 736 b. Moreover, it is configured that the guide wire 630is gripped between the thrusting plate 739 and the therapeuticinstrument elevator base 617.

The effect of this embodiment will now be described. At first, in caseof raising the therapeutic instrument 619 other than the guide wire 630,the gripping therapeutic instrument 733 as the guide wire fixing member731 is accommodated in the external channel 732 so as not to affect theoperation of the therapeutic instrument 619.

In addition, when raising the guide wire 630, the gripping therapeuticinstrument 733 is caused to protrude from the external channel 732, theoperation portion (not shown) of the gripping therapeutic instrument 733provided on the operation portion 606 side of the endoscope 601 isoperated while confirming using an endoscopic image, and the guide wire630 is gripped.

Additionally, the non-slip grooves which are substantially orthogonal tothe guide wire 630 are formed on the contact plane in the arm portion737 of the gripping therapeutic instrument 733 with respect to the guidewire 630. When the opposed grooves are staggered so that they can befitted to each other, the guide wire 630 is engaged so as to receive theforce in the shearing manner along the grooves of the arm portion 737.

Further, when the guide wire fixing member 731 is the snare 734, thesnare wire 738 at the end of the snare 734 is caused to protrude fromthe external channel 732 and opened, and the guide wire 630 is insertedinto the snare wire 738. In this state, the operation portion (notshown) of the snare provided on the operation portion 606 side of theendoscope 601 is manipulated, and the loop of the snare wire 736 isdecreased, thereby engaging the guide wire 630.

Furthermore, when the guide wire fixing member 731 is the guide wirethruster 735, the guide wire 630 is raised, and the guide wire thruster735 is pushed in from the operation portion 606 side of the endoscope601, and the guide wire 630 is sandwiched between the therapeuticinstrument elevator base 617 and the guide wire thruster 735, therebyengaging the guide wire 630.

The following advantage can be demonstrated in this embodiment. That is,in addition to the advantage similar to that of the 40th embodiment, theguide wire fixing member 731 according to this embodiment can be used tofix and release the guide wire 630 by the will of an operator, and theexisting gripping therapeutic instruments can be used, thereby readilymaking preparations.

Moreover, when there are grooves on the plane with which the guide wire630 is brought into contact, the force for fixing the guide wire 630 canbe increased. In addition, when the plane with which the guide wire 630is brought into contact is covered with resin such as rubber, the forcefor fixing the guide wire 630 can be increased and the guide wire 630can be prevented from being damaged.

Additionally, in cases where the guide wire fixing member 731 is thesnare 734, by inserting the guide wire 630 into the loop of the snarewire 738 in the first operation, the operation for assuring the guidewire 630 can be facilitated when fixing the guide wire 630 in the secondand subsequent operations.

Further, if the guide wire fixing member 731 is the guide wire thruster735, since only the operation wire 736 c for operating the guide wirethruster 735 can be inserted into the external channel 732, the insideand outside diameters of the external channel 732 can be reduced, andthe insertion ability with respect to a celoma can be hence improved.

Furthermore, FIG. 109 shows a 45th embodiment according to the presentinvention. In this embodiment, the structure of the guide wire fixingmember 621 according to the 40th embodiment is changed as follows.

Incidentally, any other parts have the same structure as the 40thembodiment, and like reference numerals denote parts similar to those inthe 40th embodiment, thereby omitting their explanation.

That is, in the guide wire fixing member 621 according to thisembodiment, one end portion of the guide wire fixture 629 is fixed tothe guide wire fixture insertion hole 628 arranged on one side of thetherapeutic instrument insertion opening window 624 of the cap portion623. The guide wire fixture 629 cuts across the therapeutic instrumentinsertion opening window 624 and passes through the other guide wirefixture insertion hole 628 of the therapeutic instrument insertionopening window 624. Then, the guide wire fixture 629 is extended to theoperation portion 606 side of the endoscope 601 through the therapeuticinstrument insertion channel 616 provided inside the insertion portion602 of the endoscope 601. Moreover, the extended end portion of theguide wire fixture 629 is configured to be connected to the operationportion (not shown) of the guide wire fixture 629 provided on theoperation portion 606 side of the endoscope 601.

The effect of this embodiment will now be described. In this embodiment,when the therapeutic instrument 619 other than the guide wire 630 israised, the guide wire fixture 629 is loosened on the operation portion606 side of the endoscope 601 so as not to prevent set-up of thetherapeutic instrument 619.

In addition, when the guide wire 630 is raised, the guide wire fixture629 is pulled from the operation portion 606 side of the endoscope 601,and the tensile force is generated to the guide wire fixture 629 cuttingacross the therapeutic instrument insertion opening window 624 of thecap portion 623. In this state, the guide wire 630 is raised by thetherapeutic instrument elevator base 617, and the guide wire 630 issandwiched and engaged between the therapeutic instrument elevator base617 and the guide wire fixture 629 cutting across the therapeuticinstrument insertion opening window 624.

The following advantage can be demonstrated in this embodiment. That is,in addition to the advantage similar to that of the 40th embodiment, inthis embodiment, the guide wire 630 can be fixed and released by thewill of an operator and there is no external channel 732 according tothe 44th embodiment, thereby improving the insertion ability to aceloma.

Additionally, FIGS. 110A to 110C show a 46th embodiment according to thepresent invention. In this embodiment, the structure of the guide wirefixing member 731 according to the 44th embodiment is changed asfollows.

That is, in this embodiment, the gripping therapeutic instrument 733 isattached to the end portion 603 of the insertion portion 602 in theendoscope 601. Further, a bending portion 741 is connected to the rearend portion of the end portion 603 of the insertion portion 602. A wirefixing ring 742 is fixed to the bending portion 741 on the base endside. Furthermore, the base end portion of the operation wire 736 a ofthe gripping therapeutic instrument 733 is fixed to the wire fixing ring742.

The effect of this embodiment will now be described. In this embodiment,as shown in FIG. 110B, when the guide wire 630 is raised, the bendingportion 741 of the endoscope 601 is once curved, and the operation wire736 a is loosened. In this state, an endoscopic image is used to confirmthat the guide wire 630 has been raised so that it can be held by thearm portion 737 of the gripping therapeutic instrument 733.

Then, curve of the bending portion 741 in the endoscope 601 is released.As a result, as shown in FIG. 110C, the operation wire 736 a becomestensed, the arm portion 737 of the gripping therapeutic instrument 733is closed, and the guide wire 630 is engaged with the arm portion 737 soas to be held therein.

The following advantage can be demonstrated in this embodiment. That is,in addition to the advantage of the 44th embodiment, in this embodiment,the external channel 732 does not have to be attached and it does nottake troubles to insert the operation wire into the therapeuticinstrument insertion channel 616 as in the 45th embodiment.

It is to be noted that the present invention is not restricted to theforegoing embodiments. For example, a shown in FIGS. 111A and 111B, theguide wire fixing member 753 consisting of the guide wire fixingmechanism portion 751 and the attachment member 752 may be attached tothe end portion 603 of the insertion portion 602 in the endoscope 601having the therapeutic instrument elevator base 617. Moreover, as shownin FIGS. 111C and 111D, the guide wire fixing member 754 consisting ofonly the guide wire fixing mechanism portion 751 included in the endportion 603 of the insertion portion 602 in the endoscope 601 may beprovided. The guide wire fixture 755 is included in the guide wirefixing mechanism portion 751.

Meanwhile, FIGS. 111A and 111C show the state in which the therapeuticinstrument elevator base 617 is raised with the end portion of thetherapeutic instrument 619 other than the guide wire 630 being led outfrom the channel opening portion 615 of the endoscope 601, and FIGS.111B and 111D show the state in which the therapeutic instrumentelevator base 617 is raised with the end portion of the guide wire 630being led out from the channel opening portion 615 of the endoscope 601,respectively.

In addition, the endoscope 601 used in the present invention may be anexisting endoscope 761 as shown in FIGS. 112A and 112B. Additionally, asillustrated in FIGS. 112C and 112D, it may be an endoscope 763 having aguide wire fixing member installation space 762 in which the guide wirefixing mechanism portion 751 is previously incorporated to the endportion 603 of the insertion portion 602 of the endoscope 601.

Further, as depicted in FIGS. 112E and 112F, it may be an endoscope 765having the attachment member 764 of the guide wire fixing mechanismportion 751. Furthermore, as shown in FIGS. 112G and 112H, it may be anendoscope 767 in which the guide wire fixing member 766 having the guidewire fixing mechanism portion 751 being undetachably included.

Moreover, although the guide wire must have the length which is twofoldof that of the therapeutic instrument when inserting/removing thetherapeutic instrument running on the guide wire in the prior art, thelength of the guide wire 630 a in this embodiment may be not more thantwofold of that of the therapeutic instrument since the guide wire 630 acan be fixed in the vicinity of the end of the endoscope. In addition,in the endoscope 601 used in the present invention, it is good enoughthat the guide wire 630 a has a length that it protrudes by an amountnot more than 40 cm from the channel opening portion 615 of theendoscope 601 toward the inside of the body and protrudes approximately10 cm from the mouth ring 4 a (see FIGS. 114A and 114B) provided on thebase end side of the therapeutic instrument 619.

That is, although the existing guide wire 5 (see FIGS. 114A and 114B)having a length of approximately 400 cm can be used, the guide wire 630Ahaving an entire length of not more than 250 cm can be used in thisembodiment as shown in FIG. 113A.

Additionally, although 1 mm or a shorter length is desirable as theoutside diameter dimension of the guide wire 630A, it does not have tobe restricted in particular.

Further, as shown in FIG. 113B, it is possible to use the extendableguide wire 630 b provided with connection portions 630 b and 630 b bywhich the extension guide wire 630 a can be connected to the base endportion side of the guide wire 630B according to needs. Alternatively,as illustrated in FIG. 113C, the guide wire 630C having a circularportion 630 d which is curved in the circular form at the end thereofcan suffice.

Furthermore, as the therapeutic instrument 619, existing therapeuticinstruments can be used as they are. A therapeutic instrument having acoated guide wire lumen in order to reduce the frictional force withrespect to the guide wire 630 or another therapeutic instrument havingthe inner surface being smoothed is more preferable in this embodiment.

Moreover, when the therapeutic instrument 619 is projecting from thechannel opening portion 615 on the end portion 603 side of the insertionportion 602, the guide wire fixing mechanism portion 751 does notobstruct the operation of the therapeutic instrument 619. When only theguide wire 630 is projecting, the guide wire fixing mechanism portion751 can fix the guide wire 630.

For example, as illustrated in connection with the 44th and 45thembodiments, the guide wire fixing mechanism portion may be operated inthe vicinity of the operation portion 606 of the endoscope 601 by usingoperation wires 736 b and 736 c and others arranged in the therapeuticinstrument insertion channel 616 or the external channel 732 providedbeside the endoscope insertion portion 602 so as to be capable of movingforward/backward, or it may be automatically operated by the guide wireidentification mechanism portion as illustrated in the 40th and 43rdembodiment.

In addition, the present invention is not restricted to the foregoingembodiments, and various modifications can be of course carried outwithout departing from the scope of the present invention.

According to the present invention, when the end portion of the guidewire inserted into the therapeutic instrument insertion channel is ledout from the end opening portion of the therapeutic instrument insertionchannel, the guide wire is releasably engaged by the guide wire fixingmeans in the vicinity of the end portion of the insertion portion.Therefore, at the time of replacing the therapeutic instrument, theguide wire does not have to be gripped on the endoscope operationportion side. Accordingly, the therapeutic instrument can be readilyreplaced in a shorter time and one operator can perform replacementwithout impairing the conventional operation method of the therapeuticinstrument or the sense of operation.

The present invention is effective in the technical field of using acombination of therapeutic instruments and the endoscope such that theoperation for replacing the therapeutic instrument is carried out byusing the guide wire, the field for manufacturing and using theendoscope, and the technical field of a treatment method for curing byusing this endoscope system.

1. An endoscope in which a therapeutic instrument insertion channel isprovided in an insertion portion inserted into a celoma and an endopening portion of said therapeutic instrument insertion channel isprovided in the vicinity of an end of said insertion portion, wherein aguide wire for guiding an insertion operation of a therapeuticinstrument is inserted into said therapeutic instrument insertionchannel; and said insertion portion has a guide wire fixing means forreleasably engaging said guide wire when said therapeutic instrumentrunning on said guide wire is inserted/removed with an end portion ofsaid guide wire being led out from said end opening portion of saidtherapeutic instrument insertion channel; wherein said guide wire fixingmeans includes a therapeutic instrument elevator base provided in thevicinity of said end opening portion of said therapeutic instrumentinsertion channel and a constituent member provided at a opposedposition when said therapeutic instrument elevator base is raised and aslit capable of engaging only said guide wire by raising said guide wireby manipulating said therapeutic instrument elevator base is provided ata top portion of a guide plane of said therapeutic instrument elevatorbase.
 2. The endoscope according to claim 1, wherein said slit isprovided on a top face of an opening portion of said therapeuticinstrument insertion channel of a distal end hard portion.
 3. Theendoscope according to claim 1, further comprising a wire contact planeprovided on a top portion of said opening portion of said therapeuticinstrument insertion channel, wherein when said elevator base isswiveled and raised and said guide wire is held/fixed between said slitand said wire contact plane, a contact portion between said wire contactplane and said guide wire on the leading end side is positioned on thebase end side away from a swiveling shaft of said elevator base.
 4. Theendoscope according to claim 1, wherein a protrusion portion throughwhich the outside diameter of said guide wire which has been elasticallydeformed passes when said elevator base is swiveled and raised isprovided to an opening portion of said slit, and a space in which theoutside diameter of said guide wire is held in cooperation with saidprotrusion portion is formed inside said slit.
 5. The endoscopeaccording to claim 4, wherein said protrusion portion is provided on theboth sides of said opening portion of said slit.
 6. The endoscopeaccording to claim 4, wherein said protrusion portion is provided in anaxial direction of an insertion portion of said opening portion of saidslit over the entire length.
 7. The endoscope according to claim 1,wherein a slit having two opposed wall surfaces is provided on the topportion of said guide plane of said therapeutic instrument elevatorbase, and only said guide wire is fixed when said wall surfaces arebrought into contact with only the outer periphery of said guide wire.8. The endoscope according to claim 1, wherein a width of said openingportion of said slit is larger than an outside diameter of said guidewire and smaller than an outside diameter of said therapeutic instrumentexternally attached to said guide wire.
 9. The endoscope according toclaim 1, wherein a central axis of said slit with respect to an axialdirection of said insertion portion is inclined relative to a centralaxis of said guide plane.
 10. The endoscope according to claim 1,wherein an intermediate stopper for stopping the operation of saidoperation member halfway at a position in a predetermined operationrange from start of raising said therapeutic instrument elevator base isprovided, and further comprising operating means for releasing saidintermediate stopper to enable the operation in the full operation rangeof said therapeutic instrument elevator base.
 11. The endoscopeaccording to claim 10, wherein a plurality of said intermediate stoppersare provided.
 12. The endoscope according to claim 10, wherein saidoperating means includes a protrusion portion provided to said operationmember and an elastic member engaging with a protrusion portion.
 13. Theendoscope according to claim 1, wherein, when said elevator base isswiveled to be lowered, a height of a wall surface of an accommodationchamber of said therapeutic instrument elevator base opposed to saidslit is higher than a bottom surface of said slit.
 14. The endoscopeaccording to claim 1, wherein said guide wire fixing means has guidewire fixing portions which are at least two movable members arrangedsubstantially in parallel to each other and can move in the directionalong which said portions move close to each other and the directionalong which said portions move away from each other.
 15. The endoscopeaccording to claim 14, wherein said two guide wire fixing portionssandwich and fix said guide wire therebetween when said guide wirefixing portions move close to each other.
 16. An endoscope in which atherapeutic instrument insertion channel is provided in an insertionportion inserted into a celoma and an end opening portion of saidtherapeutic instrument insertion channel is provided in the vicinity ofan end of said insertion portion, wherein a guide wire for guiding aninsertion operation of a therapeutic instrument is inserted into saidtherapeutic instrument insertion channel; and said insertion portion hasa guide wire fixing means for releasably engaging said guide wire whensaid therapeutic instrument running on said guide wire isinserted/removed with an end portion of said guide wire being led outfrom said end opening portion of said therapeutic instrument insertionchannel; wherein said guide wire fixing means includes a therapeuticinstrument elevator base provided in the vicinity of said end openingportion of said therapeutic instrument insertion channel and aconstituent member provided at a opposed position when said therapeuticinstrument elevator base is raised; wherein a wire contact planeprovided at the upper portion of an opening portion of said therapeuticinstrument insertion channel is included, a contact portion of saidtherapeutic instrument elevator base and said guide wire on the leadingend side is positioned on the base end side away from a swiveling axisof said elevator base when said elevator base is swiveled and raised andsaid guide wire is held/fixed between said elevator base and said wirecontact plane.
 17. An endoscope in which a therapeutic instrumentinsertion channel is provided in an insertion portion inserted into aceloma and an end opening portion of said therapeutic instrumentinsertion channel is provided in the vicinity of an end of saidinsertion portion, wherein a guide wire for guiding an insertionoperation of a therapeutic instrument is inserted into said therapeuticinstrument insertion channel; and said insertion portion has a guidewire fixing means for releasably engaging said guide wire when saidtherapeutic instrument running on said guide wire is inserted/removedwith an end portion of said guide wire being led out from said endopening portion of said therapeutic instrument insertion channel;wherein said guide wire fixing means includes a therapeutic instrumentelevator base provided in the vicinity of said end opening portion ofsaid therapeutic instrument insertion channel and a constituent memberprovided at a opposed position when said therapeutic instrument elevatorbase is raised; wherein an intermediate stopper for stopping theoperation of said operation member halfway at a position in apredetermined operation range from start of raising said therapeuticinstrument elevator base is provided, and said endoscope furthercomprises operating means for releasing said intermediate stopper toenable the operation in the full operation range of said therapeuticinstrument elevator base.
 18. The endoscope according to claim 17,wherein a plurality of said intermediate stoppers are provided.
 19. Theendoscope according to claim 17, wherein said operating means includes aprotrusion portion provided to an operating member and an elastic memberengaging with said protrusion portion.
 20. An endoscope in which atherapeutic instrument insertion channel is provided in an insertionportion inserted into a celoma and an end opening portion of saidtherapeutic instrument insertion channel is provided in the vicinity ofan end of said insertion portion, wherein a guide wire for guiding aninsertion operation of a therapeutic instrument is inserted into saidtherapeutic instrument insertion channel; and said insertion portion hasa guide wire fixing means for releasably engaging said guide wire whensaid therapeutic instrument running on said guide wire isinserted/removed with an end portion of said guide wire being led outfrom said end opening portion of said therapeutic instrument insertionchannel; wherein said guide wire fixing means includes a therapeuticinstrument elevator base provided in the vicinity of said end openingportion of said therapeutic instrument insertion channel and aconstituent member provided at a opposed position when said therapeuticinstrument elevator base is raised; wherein an operation portion isconnected to a front side end portion of the insertion portion insertedinto a celoma, the end opening portion of the therapeutic instrumentinsertion channel provided in said insertion portion is arranged at adistal end portion of said insertion portion, the elevator base forswiveling around a swiveling shaft provided at a lower portion of saidendoscope on the distal end side to raised/lowered said therapeuticinstrument, an operation lever capable of operating said elevator base,and a towing member having one end fixed to said elevator base and theother end fixed to a rotator integrally swiveling coaxially with saidoperation lever are provided; and wherein a swivel deterrent body whichis provided oppositely to said rotator and suppresses swiveling of saidrotator and a deterrence reinforcement mechanism for increasing thedeterrence by the deterrent body when said rotator rotates by thepredetermined amount are provided between said rotator and saiddeterrent body.
 21. An endoscope in which a therapeutic instrumentinsertion channel is provided in an insertion portion inserted into aceloma and an end opening portion of said therapeutic instrumentinsertion channel is provided in the vicinity of an end of saidinsertion portion, wherein a guide wire for guiding an insertionoperation of a therapeutic instrument is inserted into said therapeuticinstrument insertion channel; and said insertion portion has a guidewire fixing means for releasably engaging said guide wire when saidtherapeutic instrument running on said guide wire is inserted/removedwith an end portion of said guide wire being led out from said endopening portion of said therapeutic instrument insertion channel;wherein said guide wire fixing means includes a therapeutic instrumentelevator base provided in the vicinity of said end opening portion ofsaid therapeutic instrument insertion channel and a constituent memberprovided at a opposed position when said therapeutic instrument elevatorbase is raised; wherein said constituent member is formed by a highfriction resistance portion.
 22. The endoscope according to claim 21,wherein said friction resistance portion is formed by embedding, rubberor an elastic member.
 23. The endoscope according to claim 21, whereinsaid friction resistance portion is formed by embedding a magnet. 24.The endoscope according to claim 21, wherein a detachable distal endcover in said endoscope is formed by an elastic member, and saidfriction resistance portion is formed by extending said elastic memberto a position at which said distal end cover is opposed to saidtherapeutic instrument elevator base.
 25. An endoscope in which atherapeutic instrument insertion channel is provided in an insertionportion inserted into a celoma and an end opening portion of saidtherapeutic instrument insertion channel is provided in the vicinity ofan end of said insertion portion, wherein a guide wire for guiding aninsertion operation of a therapeutic instrument is inserted into saidtherapeutic instrument insertion channel; and said insertion portion hasa guide wire fixing means for releasably engaging said guide wire whensaid therapeutic instrument running on said guide wire isinserted/removed with an end portion of said guide wire being led outfrom said end opening portion of said therapeutic instrument insertionchannel; wherein said guide wire fixing means includes a therapeuticinstrument elevator base provided in the vicinity of said end openingportion of said therapeutic instrument insertion channel and aconstituent member provided at a opposed position when said therapeuticinstrument elevator base is raised; wherein a guide wire engagementgroove in which said guide wire is fitted in is provided on a side wallof an accommodation chamber of said therapeutic instrument elevatorbase.
 26. The endoscope according to claim 25, wherein a width of saidguide wire engagement groove is such that said guide wire can beelastically deformed and held in said guide wire engagement groove bypressing said guide wire between a side surface of said therapeuticinstrument elevator base and said guide wire engagement groove.
 27. Theendoscope according to claim 25, wherein a guide wall for leading saidguide wire to said guide wire engagement groove when said therapeuticinstrument elevator base is raised is provided on a guide plane of saidtherapeutic instrument elevator base.
 28. The endoscope according toclaim 25, wherein said guide wire engagement groove is provided at aposition where said guide wire is fixed so as to be inclined in thedirection along which an object optical system is arranged.
 29. Anendoscope in which a therapeutic instrument insertion channel isprovided in an insertion portion inserted into a celoma and an endopening portion of said therapeutic instrument insertion channel isprovided in the vicinity of an end of said insertion portion, wherein aguide wire for guiding an insertion operation of a therapeuticinstrument is inserted into said therapeutic instrument insertionchannel; and said insertion portion has a guide wire fixing means forreleasably engaging said guide wire when said therapeutic instrumentrunning on said guide wire is inserted/removed with an end portion ofsaid guide wire being led out from said end opening portion of saidtherapeutic instrument insertion channel; wherein said guide wire fixingmeans includes a therapeutic instrument elevator base provided in thevicinity of said end opening portion of said therapeutic instrumentinsertion channel and a constituent member provided at a opposedposition when said therapeutic instrument elevator base is raised; theendoscope further comprising: a first impetus giving member fixed on aproximal operation portion side of said therapeutic instrument channelopening portion at the distal end of said endoscope; a second impetusgiving member which is arranged beside said first impetus giving memberand can move substantially vertically to an axis of said insertionportion of said endoscope; a roller for thrusting said second impetusgiving member to said first impetus giving member side; guide wirefixing means constituted by an elastic member arranged between saidfirst impetus giving member and said second impetus giving member; andoperating means for towing said roller.
 30. An endoscope in which atherapeutic instrument insertion channel is provided in an insertionportion inserted into a celoma and an end opening portion of saidtherapeutic instrument insertion channel is provided in the vicinity ofan end of said insertion portion, wherein a guide wire for guiding aninsertion operation of a therapeutic instrument is inserted into saidtherapeutic instrument insertion channel; and said insertion portion hasa guide wire fixing means for releasably engaging said guide wire whensaid therapeutic instrument running on said guide wire isinserted/removed with an end portion of said guide wire being led outfrom said end opening portion of said therapeutic instrument insertionchannel; wherein said guide wire fixing means is constituted detachablywith respect to said insertion portion.
 31. The endoscope according toclaim 30, wherein said guide wire fixing means is constituted detachablywith respect to the distal end of said insertion portion.
 32. Theendoscope according to claim 30, further comprising an attachmentmechanism for attaching said guide wire fixing means to said insertionportion.
 33. The endoscope according to claim 32, wherein saidattachment mechanism consists of soft resin such as chloroethene orrubber.
 34. The endoscope according to claim 32, wherein said attachmentmechanism has a positioning member consisting of a convex portion whichis fitted in said opening of said therapeutic instrument insertionchannel.
 35. The endoscope according to claim 32, wherein saidattachment mechanism has a length extending from at least the distal endof said insertion portion to said guide wire fixing means for covering aprotrusion portion provided to said guide wire fixing means, and has amucous protection portion from which corners are eliminated as a whole.36. The endoscope according to claim 32, wherein said attachmentmechanism includes: an attachment portion formed into a substantiallycylindrical shape; a wall thickness varying portion formed so as to bewall-thick toward one end in the axial direction in said attachmentportion; at least one slit which is provided to said wall thicknessvarying portion and has an opening on said one end side; and a ringmember capable of moving on at least an outer peripheral portion of saidwall thickness varying portion in the axial direction in said attachmentportion, said wall thickness varying portion being fitted to the distalend of said insertion portion in said endoscope.
 37. The endoscopeaccording to claim 30, further comprising a guide wire fixing memberinsertion channel having at the end thereof a first opening portionwhich is opened at the distal end of said therapeutic instrumentinsertion channel and a second opening portion which is opened in thevicinity of said first opening portion, wherein said guide wire fixingmeans for holding/fixing said guide wire extended from said firstopening portion is extended from said second opening portion in order toguide said therapeutic instrument to said therapeutic target part. 38.The endoscope according to claim 37, wherein a distal end portion ofsaid guide wire fixing means has a snare shape.
 39. The endoscopeaccording to claim 37, wherein a distal end portion of said guide wirefixing means has a hook shape consisting of a soft member.
 40. Anendoscope in which a therapeutic instrument insertion channel isprovided in an insertion portion inserted into a celoma and an endopening portion of said therapeutic instrument insertion channel isprovided in the vicinity of an end of said insertion portion, wherein aguide wire for guiding an insertion operation of a therapeuticinstrument is inserted into said therapeutic instrument insertionchannel; and said insertion portion has a guide wire fixing means forreleasably engaging said guide wire when said therapeutic instrumentrunning on said guide wire is inserted/removed with an end portion ofsaid guide wire being led out from said end opening portion of saidtherapeutic instrument insertion channel; wherein said guide wire fixingmeans is arranged so as to cut across an opening of said therapeuticinstrument insertion channel in the vicinity of said opening, attachedin the longitudinal direction of said insertion portion so as to becapable of moving in the direction along which it moves close to saidtherapeutic instrument elevator base provided at said distal end portionof said endoscope and the direction along which it moves away from thesame, and has on its plane opposed to said therapeutic instrumentelevator base a guide wire fixing portion having a part with which saidguide wire is brought into contact.
 41. An endoscope in which atherapeutic instrument insertion channel is provided in an insertionportion inserted into a celoma and an end opening portion of saidtherapeutic instrument insertion channel is provided in the vicinity ofan end of said insertion portion, wherein a guide wire for guiding aninsertion operation of a therapeutic instrument is inserted into saidtherapeutic instrument insertion channel; and said insertion portion hasa guide wire fixing means for releasably engaging said guide wire whensaid therapeutic instrument running on said guide wire isinserted/removed with an end portion of said guide wire being led outfrom said end opening portion of said therapeutic instrument insertionchannel; wherein said guide wire fixing means consists of at least oneloop-like member, and a loop diameter of said loop-like member can beenlarged and decreased.
 42. An endoscope in which a therapeuticinstrument insertion channel is provided in an insertion portioninserted into a celoma and an end opening portion of said therapeuticinstrument insertion channel is provided in the vicinity of an end ofsaid insertion portion, wherein a guide wire for guiding an insertionoperation of a therapeutic instrument is inserted into said therapeuticinstrument insertion channel; and said insertion portion has a guidewire fixing means for releasably engaging said guide wire when saidtherapeutic instrument running on said guide wire is inserted/removedwith an end portion of said guide wire being led out from said endopening portion of said therapeutic instrument insertion channel;wherein said guide wire fixing means has a groove whose width is smallerthan the outside diameter of said guide wire in some measure on itsplane opposed to said therapeutic instrument elevator base arranged atthe distal end of said insertion portion.
 43. An endoscope in which atherapeutic instrument insertion channel is provided in an insertionportion inserted into a celoma and an end opening portion of saidtherapeutic instrument insertion channel is provided in the vicinity ofan end of said insertion portion, wherein a guide wire for guiding aninsertion operation of a therapeutic instrument is inserted into saidtherapeutic instrument insertion channel; and said insertion portion hasa guide wire fixing means for releasably engaging said guide wire whensaid therapeutic instrument running on said guide wire isinserted/removed with an end portion of said guide wire being led outfrom said end opening portion of said therapeutic instrument insertionchannel; wherein said guide wire fixing means has a guide wire fixingportion having irregularities formed thereto on its plane with whichsaid guide wire is brought into contact.
 44. The endoscope according toclaim 43, wherein said guide wire fixing portion consists of a pair ofguide wire fixing members sandwiching said guide wire therebetween. 45.The endoscope according to claim 44, wherein, in said irregularities,convex portions in one guide wire fixing member are fitted in concaveportions in the other guide wire fixing member.
 46. The endoscopeaccording to claim 43, wherein said irregularities consist of stepswhich are substantially orthogonal to said guide wire.
 47. An endoscopein which a therapeutic instrument insertion channel is provided in aninsertion portion inserted into a celoma and an end opening portion ofsaid therapeutic instrument insertion channel is provided in thevicinity of an end of said insertion portion, wherein a guide wire forguiding an insertion operation of a therapeutic instrument is insertedinto said therapeutic instrument insertion channel; and said insertionportion has a guide wire fixing means for releasably engaging said guidewire when said therapeutic instrument running on said guide wire isinserted/removed with an end portion of said guide wire being led outfrom said end opening portion of said therapeutic instrument insertionchannel; wherein a material which consists of an elastic member such asrubber and has the large friction resistance is arranged on a plane ofsaid guide wire fixing means with which said guide wire is brought intocontact.
 48. An endoscope in which a therapeutic instrument insertionchannel is provided in an insertion portion inserted into a celoma andan end opening portion of said therapeutic instrument insertion channelis provided in the vicinity of an end of said insertion portion, whereina guide wire for guiding an insertion operation of a therapeuticinstrument is inserted into said therapeutic instrument insertionchannel; and said insertion portion has a guide wire fixing means forreleasably engaging said guide wire when said therapeutic instrumentrunning on said guide wire is inserted/removed with an end portion ofsaid guide wire being led out from said end opening portion of saidtherapeutic instrument insertion channel; wherein said guide wire fixingmeans is arranged in a transparent substantially-cylindrical memberhaving a therapeutic instrument insertion opening portion through whichsaid therapeutic instrument projecting from the opening of saidtherapeutic instrument insertion channel can pass.
 49. An endoscope inwhich a therapeutic instrument insertion channel is provided in aninsertion portion inserted into a celoma and an end opening portion ofsaid therapeutic instrument insertion channel is provided in thevicinity of an end of said insertion portion, wherein a guide wire forguiding an insertion operation of a therapeutic instrument is insertedinto said therapeutic instrument insertion channel; and said insertionportion has a guide wire fixing means for releasably engaging said guidewire when said therapeutic instrument running on said guide wire isinserted/removed with an end portion of said guide wire being led outfrom said end opening portion of said therapeutic instrument insertionchannel; wherein said guide wire fixing means has a guide wireidentification mechanism for identifying said guide wire and saidtherapeutic instrument other than said guide wire.
 50. The endoscopeaccording to claim 49, wherein said guide wire identification mechanismhas a protrusion portion having at least a part which protrudes on theopening of said therapeutic instrument insertion channel so as to becapable of moving forward and backward.
 51. The endoscope according toclaim 50, wherein said guide wire identification mechanism has aprotrusion portion which protrudes on the opening of said therapeuticinstrument insertion channel from the base end side in the longitudinaldirection of said insertion portion so as to be capable of movingforward and backward, and said protrusion portion has a gap whose widthis larger than the diameter of said guide wire on a side opposed to saidguide wire.
 52. The endoscope according to claim 49, further comprisinga guide wire fixing member or a guide wire identification member whichcan move with respect to said guide wire fixing means and to whichimpetus is given at a first position where said guide wire is fixed byan elastic member or a second position where said therapeutic instrumentother than said guide wire can be inserted.
 53. The endoscope accordingto claim 52, wherein said guide wire fixing means has a click mechanismwhich can engage at least one of said guide wire fixing member or saidguide wire identification member at said first position or said secondposition.
 54. The endoscope according to claim 53, wherein said clickmechanism consists of a click pin and a click groove for guiding saidclick pin.
 55. The endoscope according to claim 54, wherein said clickgroove has a step for preventing reverse rotation of said click pin. 56.The endoscope according to claim 55, wherein said click pin is rotatablyattached to a moving member consisting of at least either said guidewire fixing member or said guide wire identification member, and thereare provided a hole in which said click pin is fitted when said movingmember reaches the vicinity of the opposite side to that where impetusis given and a step for preventing reverse rotation at a turnback pointin said click groove in such a manner that an outward route and aninward route of said click pin are different from each other when saidmoving member reciprocates between said first position and said secondposition.
 57. The endoscope according to claim 54, wherein said clickpin is rotatably attached to a moving member consisting of at leasteither said guide wire fixing member and said guide wire identificationmember, said endoscope includes one convex portion provided on the sidewhere impetus is given to said guide wire fixing portion, a first convexportion and a second convex portion provided on the opposite side to theside where impetus is given and a concave portion provided between saidtwo convex portions, and steps for preventing reverse rotation areprovided at all turnback points in such a manner that an outward routeand an inward route of said click pin are different from each other whensaid guide wire fixing portion reciprocates between said first positionand said second position.
 58. The endoscope according to claim 49,wherein said guide wire fixing means interlocks with said guide wireidentification mechanism.
 59. The endoscope according to claim 58,wherein said guide wire fixing means has a part which is caught by saidguide wire identification mechanism portion.
 60. An endoscopecomprising: an insertion portion inserted into a celoma; an operationportion connected to a proximal end portion of said insertion portion;and a therapeutic instrument elevator base which is arranged at thedistal end portion of said insertion portion and can be operated by saidoperation portion, wherein a slit which can engage only a guide wire byraising said guide wire by operating said therapeutic instrumentelevator base is provided at a top portion on a guide plane of saidtherapeutic instrument elevator base.
 61. The endoscope according toclaim 60, wherein a slit having two opposed wall surfaces is provided onthe top portion of said guide plane of said therapeutic instrumentelevator base, and only said guide wire is fixed when said wall surfacesare brought into contact with only the outer periphery of said guidewire.
 62. The endoscope according to claim 60, wherein a width of anopening portion of said slit is larger than the outside diameter of saidguide wire and smaller than the outside diameter of a therapeuticinstrument externally attached to said guide wire.
 63. The endoscopeaccording to claim 60, wherein said slit is provided on the top face ofa therapeutic instrument insertion channel opening portion of an endhard portion in said endoscope.
 64. The endoscope according to claim 60,wherein a wire contact plane is provided on the top portion of theopening portion of said therapeutic instrument insertion channelprovided at the distal end of said endoscope a contact portion of saidslit and said guide wire on the leading end side is positioned on thebase end side away from a swiveling shaft of said elevator base whensaid elevator base is swiveled and raised and said guide wire isheld/fixed between said slit and said wire contact plane.
 65. Theendoscope according to claim 60, further comprising an object opticalsystem at the distal end portion of said endoscope wherein said objectoptical system is set in such a manner that a part of said therapeuticinstrument elevator base exists in an observation visual field when saidguide wire is fixed and a part of said guide wire which is fixed andenters said observation visual field is focused.
 66. The endoscopeaccording to claim 60, wherein a protrusion portion through which theoutside diameter of said guide wire passes after being elasticallydeformed when said elevator base is swiveled and raised is provided atthe opening portion of said slit, and a space in which the outsidediameter of said guide wire is held in cooperation with said protrusionportion is formed inside said slit.
 67. The endoscope according to claim66, wherein said protrusion portion is provided on both sides of theopening portion of said slit.
 68. The endoscope according to claim 66,wherein said protrusion portion is provided in the axial direction ofsaid insertion portion of said opening portion of said slit over theentire length.
 69. The endoscope according to claim 60, wherein anintermediate stopper for stopping the operation of said operation memberof said therapeutic instrument elevator base halfway at a position in apredetermined operation range from start of raising said therapeuticinstrument elevator base is provided, and said endoscope furtherincludes operating means which can release said intermediate stopper andenables operation in the full operation range of said operation member.70. The endoscope according to claim 69, wherein a plurality of saidintermediate stopper are provided.
 71. The endoscope according to claim69, wherein said operating means consists of a protrusion portionprovided to said operation member and an elastic member engaging withsaid protrusion portion.
 72. The endoscope according to claim 60,wherein, when said elevator base is swiveled and lowered, a height of awall surface of an accommodation chamber of said therapeutic instrumentelevator base opposed to said slit is higher than a bottom surface ofsaid slit.
 73. The endoscope according to claim 60, wherein saidtherapeutic instrument elevator base has a guide plane which is opposedto the opening portion of said therapeutic instrument insertion channeland guides said therapeutic instrument, another plane facing the distalend of said endoscope and a connection plane for smoothly connectingsaid guide plane with another plane, and said slit is provided on saidconnection plane or from said connection plane to another plane.
 74. Theendoscope according to claim 60, wherein a central axis relative to anaxial direction of the insertion portion of said slit is inclined withrespect to a central axis of said guide plane.
 75. An endoscope systemcomprising: an endoscope in which a therapeutic instrument insertionchannel is provided in an insertion portion inserted into a celoma, anopening portion at the distal end of said therapeutic instrumentinsertion channel is provided in the vicinity of the distal end of saidinsertion portion and a therapeutic instrument insertion opening as anopening portion of said therapeutic instrument insertion channel isprovided on the proximal side of an operation portion; a guide wirewhich can pass through said therapeutic instrument insertion channel;and a therapeutic instrument which has a pipe through which said guidewire can pass and which can be inserted into said therapeutic instrumentinsertion channel, wherein said therapeutic instrument has a protrusionlength from said distal end opening portion which is required fortreatment and a protrusion length from said therapeutic instrumentinsertion opening which is required for operation on the proximal sidewith said therapeutic instrument being inserted into said therapeuticinstrument insertion channel, guide wire fixing means for releasablyengaging said guide wire when inserting/removing said therapeuticinstrument running on said guide wire with the distal end portion ofsaid guide wire inserted through said therapeutic instrument insertionchannel being led out from said distal end opening portion is providedin the vicinity of the distal end portion of said insertion portion, andsaid guide wire has a length projecting from the proximal end portion ofsaid therapeutic instrument with the end portion of said therapeuticinstrument being drawn to the front side of said operation portion fromsaid engagement position and engaged by said guide wire fixing means;wherein a slit which can engage only said guide wire by raising saidguide wire by operating a therapeutic instrument elevator base providedin the vicinity of the end opening portion of said therapeuticinstrument insertion channel is provided on a top portion on a guideplane of said therapeutic instrument elevator base.
 76. The endoscopesystem according to claim 75, further comprising a protrusion portionprovided on an upper portion of the opening portion of said therapeuticinstrument insertion channel, wherein a contact portion of saidprotrusion portion and said guide wire on the leading end side ispositioned on the base end side away from a swiveling shaft of saidelevator base when said elevator base is swiveled and raised and saidguide wire is held/fixed between said slit and said protrusion portion.77. The endoscope system according to claim 75, wherein an intermediatestopper for stopping the operation of said operation member halfway at aposition in a predetermined operation range from start of raising saidtherapeutic instrument elevator base is provided, and said endoscopesystem further includes operating means which releases said intermediatestopper and can operate in the full operation range of said operationmember.
 78. The endoscope system according to claim 77, wherein saidoperating means consists of a protrusion portion provided to saidoperation member and an elastic member which engages with saidprotrusion portion.
 79. The endoscope system according to claim 75,wherein said slit has two opposed wall surfaces and said wall surfacesare set so as to engage only the outer peripheral surface of said guidewire.
 80. The endoscope system according to claim 75, wherein a width ofsaid slit is set larger than the outside diameter of said guide wire andsmaller than the outside diameter of a therapeutic instrument externallyattached to said guide wire.
 81. The endoscope system according to claim75, wherein a central axis of said slit relative to the direction of acentral axis of said insertion portion is inclined with respect to acentral axis of said guide plane.
 82. An endoscope system comprising: anendoscope in which a therapeutic instrument insertion channel isprovided in an insertion portion inserted into a celoma, an openingportion at the distal end of said therapeutic instrument insertionchannel is provided in the vicinity of the distal end of said insertionportion and a therapeutic instrument insertion opening as an openingportion of said therapeutic instrument insertion channel is provided onthe proximal side of an operation portion; a guide wire which can passthrough said therapeutic instrument insertion channel; and a therapeuticinstrument which has a pipe through which said guide wire can pass andwhich can be inserted into said therapeutic instrument insertionchannel, wherein said therapeutic instrument has a protrusion lengthfrom said distal end opening portion which is required for treatment anda protrusion length from said therapeutic instrument insertion openingwhich is required for operation on the proximal side with saidtherapeutic instrument being inserted into said therapeutic instrumentinsertion channel, guide wire fixing means for releasably engaging saidguide wire when inserting/removing said therapeutic instrument runningon said guide wire with the distal end portion of said guide wireinserted through said therapeutic instrument insertion channel being ledout from said distal end opening portion is provided in the vicinity ofthe distal end portion of said insertion portion, and said guide wirehas a length projecting from the proximal end portion of saidtherapeutic instrument with the end portion of said therapeuticinstrument being drawn to the front side of said operation portion fromsaid engagement position and engaged by said guide wire fixing means;wherein an entire length of said guide wire is set to be not more thantwofold of an entire length of said therapeutic instrument.
 83. Anendoscope system comprising: an endoscope in which a therapeuticinstrument insertion channel is provided in an insertion portioninserted into a celoma, an opening portion at the distal end of saidtherapeutic instrument insertion channel is provided in the vicinity ofthe distal end of said insertion portion and a therapeutic instrumentinsertion opening as an opening portion of said therapeutic instrumentinsertion channel is provided on the proximal side of an operationportion; a guide wire which can pass through said therapeutic instrumentinsertion channel; and a therapeutic instrument which has a pipe throughwhich said guide wire can pass and which can be inserted into saidtherapeutic instrument insertion channel, wherein said therapeuticinstrument has a protrusion length from said distal end opening portionwhich is required for treatment and a protrusion length from saidtherapeutic instrument insertion opening which is required for operationon the proximal side with said therapeutic instrument being insertedinto said therapeutic instrument insertion channel, guide wire fixingmeans for releasably engaging said guide wire when inserting/removingsaid therapeutic instrument running on said guide wire with the distalend portion of said guide wire inserted through said therapeuticinstrument insertion channel being led out from said distal end openingportion is provided in the vicinity of the distal end portion of saidinsertion portion, and said guide wire has a length projecting from theproximal end portion of said therapeutic instrument with the end portionof said therapeutic instrument being drawn to the front side of saidoperation portion from said engagement position and engaged by saidguide wire fixing means; wherein the entire length of said guide wire isset in such a manner that said guide wire can protrude from the openingportion of said therapeutic instrument insertion channel and protrudefrom the front end portion of said therapeutic instrument with thedistal end portion of said therapeutic instrument being pulled to saidoperation side on the proximal side from said engagement position andsaid guide wire being fixed to said guide wire fixing means.
 84. Anendoscope system comprising: an endoscope in which a therapeuticinstrument insertion channel is provided in an insertion portioninserted into a celoma, an opening portion at the distal end of saidtherapeutic instrument insertion channel is provided in the vicinity ofthe distal end of said insertion portion and a therapeutic instrumentinsertion opening as an opening portion of said therapeutic instrumentinsertion channel is provided on the proximal side of an operationportion; a guide wire which can pass through said therapeutic instrumentinsertion channel; and a therapeutic instrument which has a pipe throughwhich said guide wire can pass and which can be inserted into saidtherapeutic instrument insertion channel, wherein said therapeuticinstrument has a protrusion length from said distal end opening portionwhich is required for treatment and a protrusion length from saidtherapeutic instrument insertion opening which is required for operationon the proximal side with said therapeutic instrument being insertedinto said therapeutic instrument insertion channel, guide wire fixingmeans for releasably engaging said guide wire when inserting/removingsaid therapeutic instrument running on said guide wire with the distalend portion of said guide wire inserted through said therapeuticinstrument insertion channel being led out from said distal end openingportion is provided in the vicinity of the distal end portion of saidinsertion portion, and said guide wire has a length projecting from theproximal end portion of said therapeutic instrument with the end portionof said therapeutic instrument being drawn to the front side of saidoperation portion from said engagement position and engaged by saidguide wire fixing means; wherein a protrusion length of said therapeuticinstrument from said therapeutic instrument insertion opening is set to30 to 60 cm in the state where the end portion of said therapeuticinstrument is pulled to said operation portion side on the front sidefrom said engagement position and said guide wire is engaged by saidguide wire fixing means, and a length of said guide wire protruding fromthe proximal side of said therapeutic instrument in the same state isset to not more than 20 cm.
 85. An endoscope comprising: an elongatedinsertion portion; a therapeutic instrument insertion channel providedin the insertion portion; a therapeutic instrument elevator base forcontrolling directions of leading portions of a therapeutic instrumentand a guide wire inserted in the therapeutic insertion channel, theleading portions of the therapeutic instrument and the guide wire beingout from an opening of the therapeutic insertion channel at a distal endof the insertion portion; and a guide wire fixing mechanism thatrestricts relative movement of the guide wire with respect to theinsertion portion in a longitudinal direction of the insertion portion,at a portion close to the opening of the therapeutic insertion channel.86. The endoscope according to claim 85, which is applied to surgery ona pancreatic/hepatic duct.
 87. The endoscope according to claim 85,wherein the guide wire fixing mechanism includes a portion by which theguide wire is to be releasably held.
 88. The endoscope according toclaim 87, wherein the guide wire fixing mechanism includes a slit whichis formed in a guide surface of the therapeutic instrument elevator basein an axial direction of the insertion portion in such a manner as toenable the guide wire to be held by the slit.
 89. The endoscopeaccording to claim 88, wherein the guide wire fixing mechanism restrictsthe movement of the guide wire by holding the guide wire with the slit.90. The endoscope according to claim 89, wherein the slit is providedwith a V-shaped cross section.
 91. The endoscope according to claim 89,wherein the slit has a center line provided at a position different froma center of the guide surface of the therapeutic instrument elevatorbase which is determined with respect to the axial direction of theinsertion portion.
 92. The endoscope according to claim 89, wherein theslit has a center line provided at a position deviating from a center ofthe guide surface of the therapeutic instrument elevator base which isdetermined with respect to the axial direction of the insertion point.93. The endoscope according to claim 89, wherein an inner surface of theslit has a higher frictional resistance than other portion of the guidesurface of the therapeutic instrument elevator base.
 94. The endoscopeaccording to claim 89, wherein the slit is formed such that an endportion of the slit, which is proximal to the opening of the therapeuticinstrument channel, contacts the guide wire, with the movement of theguide wire restricted.
 95. The endoscope according to claim 89, whereinthe slit has a size which is smaller than an outside diameter of thetherapeutic instrument, and is greater than an outside diameter of theguide wire.
 96. The endoscope according to claim 85, wherein the guidewire fixing mechanism includes an elastic member which is located on aportion of a distal end structural member located in the distal end ofthe insertion portion, which contacts the guide wire, when the movementof the guide wire is restricted.
 97. The endoscope according to claim85, wherein an optical system is arranged at a position at which a partof the guide wire is shown in an observation image, when the relativemovement of the guide wire is restricted.
 98. The endoscope according toclaim 97, wherein at least a part of the guide wire fixing mechanism isprovided at the therapeutic instrument elevator base, and the movementof the guide wire is restricted by the guide wire fixing mechanism whenthe therapeutic instrument elevator base is raised.
 99. An endoscopecomprising: an elongated insertion portion; a therapeutic instrumentinsertion channel provided in the insertion portion, a therapeuticinstrument elevator base for controlling directions of leading portionsof a therapeutic instrument and a guide wire inserted in the therapeuticinsertion channel, the leading portions of the therapeutic instrumentand the guide wire being out from an opening of the therapeuticinsertion channel at a distal end of the insertion portion; a guide wirefixing mechanism that restricts relative movement of the guide wire withrespect to the insertion portion in a longitudinal direction of theinsertion portion, at a portion close to the opening of the therapeuticinsertion channel; and a brake mechanism for maintaining the movement ofthe guide wire restricted.
 100. The endoscope according to claim 99,wherein at least a part of the guide wire fixing mechanism is providedat the therapeutic instrument elevator base, the movement of the guidewire is restricted by the guide wire fixing mechanism when thetherapeutic instrument elevator base is raised, and the brake mechanismkeeps the movement of the guide wire restricted by maintaining aposition of an elevator base operation member for operating thetherapeutic instrument elevator base.
 101. The endoscope according toclaim 100, wherein an object optical system is arranged at a position atwhich a part of the guide wire is shown in an observation image, whenthe relative movement of the guide wire is restricted.
 102. An endoscopecomprising: an elongated insertion portion; a therapeutic instrumentinsertion channel provided in the insertion portion, a therapeuticinstrument elevator base for controlling directions of leading portionsof a therapeutic instrument and a guide wire inserted in the therapeuticinsertion channel, the leading portions of the therapeutic instrumentand the guide wire being out from an opening of the therapeuticinsertion channel at a distal end of the insertion portion; and a guidewire fixing mechanism that restricts relative movement of the guide wirewith respect to the insertion portion in a longitudinal direction of theinsertion portion, at a portion close to the opening of the therapeuticinsertion channel, at least a portion of the guide wiring fixingmechanism being provided at the therapeutic instrument elevator base,wherein the therapeutic instrument elevator base has a first range inwhich the directions of the leading portions of the therapeuticinstrument and the guide wire are controlled, and a second range inwhich the relative movement of the guide wire is restricted.
 103. Theendoscope according to claim 102, wherein an object optical system isarranged at a position at which a part of the guide wire is shown in anobservation image, when the relative movement of the guide wire isrestricted.
 104. The endoscope according to claim 103, wherein saidguide wire fixing means is arranged in the vicinity of said therapeuticinstrument elevator base provided at a distal end of said insertionportion.
 105. The endoscope according to claim 104, further comprisingoperation transmitting means includes an operation lever provided tosaid operation portion and an operation wire having one end connected tosaid operation lever and the other end connected to said guide wirefixing means.
 106. The endoscope according to claim 105, wherein arotating shaft of said operation lever is provided at a positiondifferent from the rotating shaft of elevator base raised lever. 107.The endoscope according to claim 106, wherein said rotating shaft ofsaid operating lever is provided at a position which is substantiallyorthogonal to said rotating shaft of said therapeutic instrumentelevator base raised lever.
 108. The endoscope according to claim 106,wherein said rotating shaft of said therapeutic instrument elevator baseraised lever is provided on an axis which is substantially orthogonal toa central axis of said insertion portion, and said rotating shaft ofsaid operation lever is provided on an axis which is substantiallyparallel to said central axis of said insertion portion.
 109. Theendoscope according to claim 106, wherein a therapeutic instrumentinsertion opening for leading said therapeutic instrument to saidtherapeutic instrument insertion channel is provided to a grip forholding said operation portion, and said operation lever is provided atan end portion of said grip on said insertion portion side.
 110. Theendoscope according to claim 106, wherein said therapeutic instrumentset-up lever is provided on the front side away from said grip and saidoperation lever is provided on said insertion portion side away fromsaid grip.
 111. The endoscope according to claim 104, wherein said guidewire fixing means has a snare shape.
 112. The endoscope according toclaim 111, wherein a fixing member which can temporarily fix said guidewire fixing means is provided to said endoscope in the vicinity of saidopening portion side of said therapeutic instrument insertion channel.113. The endoscope according to claim 104, wherein said guide wirefixing means has a hook-like shape.
 114. The endoscope according toclaim 113, further comprising: a fixing portion for fixing said guidewire; a guide wire fixing member consisting of an arm portion providedon the base end side of said fixing portion and a support shaft forswiveling and supporting said arm portion so as to be orthogonal to saidarm portion; a swivel mechanism for swiveling said support shaft of saidguide wire fixing member; and a tow wire which is inserted into saidinsertion portion of said endoscope in order to remotely operate saidswivel mechanism, wherein said fixing member is brought into contactwith an outside diameter portion of said guide wire and held and fixedbetween said outside diameter portion and a main body portion of saidinsertion portion at the end thereof by swiveling said arm portion. 115.The endoscope according to claim 114, wherein at least said supportshaft and said swivel mechanism are water-tightly arranged inside saiddistal end hard portion of said endoscope.
 116. The endoscope accordingto claim 104, wherein a guide wire fixing elevator base capable ofmoving to an engagement position where said guide wire which is insertedinto said therapeutic instrument insertion channel and guides saidtherapeutic instrument is releasably engaged and an engagement releasingposition where engagement of said guide wire is released is provided atsaid end portion of said insertion portion as said guide wire fixingmeans.
 117. The endoscope according to claim 116, wherein operatingmeans for operating engagement or release of said guide wire by saidguide wire fixing elevator base is provided to said operation portion ofsaid endoscope.
 118. The endoscope according to claim 116, wherein saidguide wire is held and fixed by a wall surface portion of a therapeuticinstrument insertion path arranged at the distal end of said endoscopeand said guide wire fixing elevator base.
 119. The endoscope accordingto claim 116, wherein said guide wire fixing elevator base is providedon said therapeutic instrument elevator base for raising saidtherapeutic instrument in the direction of a visual field.
 120. Theendoscope according to claim 116, wherein an opening portion is providedon a guide plane of said therapeutic instrument elevator base on whichsaid therapeutic instrument is arranged, and said guide wire fixingelevator base is provided at said opening portion.
 121. The endoscopeaccording to claim 116, wherein said guide wire fixing elevator base isprovided in such a manner that a guide plane of said guide wire fixingelevator base is smoothly connected to that of said therapeuticinstrument elevator base when said guide wire fixing elevator base islowered.
 122. The endoscope according to claim 116, wherein a raisedangle of said guide wire fixing elevator base exceeds that of saidtherapeutic instrument elevator base.
 123. The endoscope according toclaim 116, wherein an elastic member is provided at a guide wire contactposition provided when said guide wire is fixed by said guide wirefixing elevator base.
 124. The endoscope according to claim 116, whereina protrusion is provided at a guide wire contact position of saidelevator base provided when said guide wire is fixed by said guide wirefixing elevator base.
 125. The endoscope according to claim 104, furthercomprising: a biasing member capable of moving in the direction which issubstantially vertical to said therapeutic instrument insertion path atsaid distal end portion of said endoscope; guide wire fixing meansconstituted by a spring material assisting movement of said biasingmember; and operation transmitting means enabling operation of fixationand release of said guide wire by said guide wire fixing means.
 126. Theendoscope according to claim 125, wherein said guide wire fixing meansis constituted by providing a torque transmission member between saidbiasing member and said operation transmitting means.
 127. The endoscopeaccording to claim 104, wherein said guide wire fixing means isconstituted by fixing an end portion of a fixing operation wireprojecting from a guide pipe provided to said endoscope in the vicinityof said opening portion of said therapeutic instrument insertion channelon the end side.
 128. The endoscope according to claim 127, wherein anend portion of said guide wire fixing means is fixed so as to be capableof swiveling.
 129. The endoscope according to claim 103, wherein saidguide wire fixing means is included in the vicinity of the distal end ofsaid insertion portion.
 130. The endoscope according to claim 103,wherein said guide wire fixing means is arranged in the vicinity of saidopening.
 131. The endoscope according to claim 130, wherein said guidewire fixing means is arranged at a position which is in contact with thevicinity of the surface of said insertion portion or a position in thevicinity of the surface and a position away from an observation windowarranged at the end of said insertion portion.
 132. The endoscopeaccording to claim 103, further comprising operating means for operatingsaid guide wire fixing means.
 133. The endoscope according to claim 132,wherein said operating means is provided to said operation portion ofsaid endoscope.
 134. The endoscope according to claim 132, wherein atransmission mechanism for transmitting the operation of said operatingmeans is provided between said operating means and said guide wirefixing means.
 135. The endoscope according to claim 134, wherein saidtransmission mechanism is an operation wire arranged in said therapeuticinstrument insertion channel.
 136. The endoscope according to claim 134,wherein said transmission mechanism is arranged in an external channelprovided between the vicinity of the distal end of said insertionportion and the front side along the side surface of said endoscope.137. The endoscope according to claim 136, wherein said transmissionmechanism is an operation wire arranged in said external channel. 138.The endoscope according to claim 132, wherein a member for fixing saidoperation wire is provided in the vicinity of the base end of a bendingportion in said endoscope.
 139. The endoscope according to claim 132,wherein said operating means and said endoscope operation portion arearranged so as to be distanced from each other.
 140. An endoscopecomprising: an elongated insertion portion; a therapeutic instrumentinsertion channel provided in the insertion portion; a therapeuticinstrument elevator base for controlling directions of leading portionsof a therapeutic instrument and a guide wire inserted in the therapeuticinsertion channel, the leading portions of the therapeutic instrumentand the guide wire being out from an opening of the therapeuticinsertion channel at a distal end of the insertion portion; and guidewire fixing means that restricts relative movement of the guide wirewith respect to the insertion portion in a longitudinal direction of theinsertion portion, at a portion close to the opening of the therapeuticinsertion channel.
 141. The endoscope according to claim 140, wherein apart of the guide wire fixing means is provided at the therapeuticinstrument elevator base, and the movement of the guide wire isrestricted by the guide wire fixing means when the therapeuticinstrument elevator base is raised.
 142. The endoscope according toclaim 140, wherein the guide wire fixing means is provided separatelywith the therapeutic instrument elevator base.
 143. The endoscopeaccording to claim 140, which further comprises brake means formaintaining the movement of the guide wire restricted.
 144. Theendoscope according to claim 140, wherein an object optical system isarranged at a position at which a part of the guide wire is shown in anobservation image, when the relative movement of the guide wire isrestricted.